Job Description (JD)Data Entry Operator (DEO) – PM-JAYDepartment
PM-JAY / Medical Records / Billing
Reports To
PM-JAY Coordinator / TPA Executive / Hospital Administrator
Job Purpose
To ensure accurate registration, verification, documentation, claim processing, and data management of PM-JAY beneficiaries in accordance with National Health Authority (NHA) guidelines and hospital policies.
Key ResponsibilitiesPatient Registration
- Verify beneficiary eligibility through the PM-JAY portal.
- Register eligible patients accurately on the PM-JAY system.
- Generate Transaction Management System (TMS) IDs and maintain beneficiary records.
- Collect and verify Aadhaar, ABHA, ration card, and other required documents.
Data Entry & Documentation
- Enter patient demographic, clinical, diagnostic, and treatment details accurately.
- Upload all mandatory documents on the PM-JAY portal.
- Maintain complete digital and physical records of all PM-JAY cases.
- Ensure confidentiality and security of patient information.
Pre-Authorization & Claims
- Prepare and upload pre-authorization requests.
- Coordinate with treating consultants for required clinical documents.
- Submit claims within prescribed timelines.
- Track claim status and respond to insurer/authority queries promptly.
- Assist in claim resubmission and deficiency compliance.
Coordination
- Coordinate with consultants, nursing staff, billing department, MRD, and insurance coordinators.
- Liaise with PM-JAY district/state authorities whenever required.
- Assist beneficiaries regarding scheme benefits and documentation requirements.
Record Management
- Maintain daily admission and discharge records.
- Update PM-JAY dashboards and MIS reports.
- Preserve all documents for audit purposes.
- Ensure proper filing of approvals, discharge summaries, investigation reports, consent forms, and claim documents.
Compliance
- Follow PM-JAY operational guidelines and NHA protocols.
- Ensure zero fraudulent or duplicate entries.
- Support internal, external, and government audits.
- Maintain compliance with NABH and hospital quality standards.
Daily Reporting
- Daily beneficiary registration report.
- Pre-authorization pending report.
- Claim submission report.
- Claim deficiency report.
- Rejected claim tracker.
- Pending document tracker.
- Monthly MIS submission.
Required Qualifications
- Graduate in any discipline (preferred).
- Diploma/Certificate in Computer Applications.
- Experience in PM-JAY, TPA, Medical Billing, or Hospital Administration preferred.
Experience
- 1–3 years in hospital data entry, PM-JAY, insurance, or medical records.
- Freshers with relevant computer skills may also be considered.
Technical Skills
- PM-JAY BIS and TMS Portal
- MS Excel, Word, Outlook
- Hospital Information Management System (HIMS/HMIS)
- Medical documentation
- Typing speed of at least 35 WPM (English) and proficiency in local language typing is desirable.
Key Competencies
- High accuracy in data entry
- Attention to detail
- Good communication skills
- Time management
- Documentation skills
- Teamwork
- Problem-solving ability
- Confidentiality and ethical conduct
Key Performance Indicators (KPIs)
- ≥98% data entry accuracy.
- 100% claim submission within prescribed timelines.
- Minimal claim rejections due to documentation errors.
- Timely response to claim deficiencies.
- Complete and audit-ready documentation.
- Compliance with PM-JAY and hospital SOPs.
- Daily MIS submission without delay.
Working Conditions
- 8–9 hour duty with rotational shifts as per hospital requirements.
- Availability during audits, inspections, and high patient load periods.
- Computer-based work requiring continuous coordination with clinical and administrative departments.
Pay: ₹13,582.17 - ₹15,000.00 per month
Work Location: In person
