JOB DESCRIPTION – AYUSHMAN MITRA
Department: Ayushman / PM-JAY Department
Reporting To: Hospital Manager / Ayushman In-charge
Key Responsibilities
- Verify Ayushman beneficiary eligibility and complete patient registration.
- Handle BIS/TMS entries and documentation.
- Submit and follow up on pre-authorizations and enhancements.
- Coordinate with doctors for required medical documents and clarifications.
- Update treatment and discharge details in TMS.
- Prepare and submit final claims within the prescribed timeline.
- Monitor queries, rejected claims and resubmissions.
- Maintain Ayushman registers, records and daily/monthly MIS.
- Track pending and outstanding claims and coordinate with Accounts for payment reconciliation.
- Coordinate with Front Office, Billing, Nursing, Medical Records and Accounts departments.
- Ensure compliance with PM-JAY guidelines and hospital SOPs.
- Provide proper guidance to Ayushman patients and attendants regarding the cashless process.
Qualification
Graduate; experience in Ayushman/TPA/Insurance/Hospital Billing preferred.
Key Skills
Computer knowledge, TMS/BIS knowledge, documentation, communication, coordination and strong follow-up skills.
Pay: ₹15,000.00 - ₹25,000.00 per month
Benefits:
Work Location: In person
