Job Purpose:
To ensure timely realization of payments from Government Healthcare Schemes and Institutional Panels by managing the complete receivable lifecycle, including claim submission, follow-up, query resolution, reconciliation, deductions management, and coordination with internal departments and external authorities.
Key Responsibilities:
· Log into government panel portals multiple times daily; track claim status and ensure zero backlog of NMIs (Not Moved Items) or unresolved cases.
· Monitor ageing reports daily; prepare panel-wise outstanding reports and prioritize high-value pending payments.
· Escalate long-pending cases to the Billing Head as per defined timelines.
· Track submitted claims from submission to payment realization.
· Conduct regular follow-ups with concerned authorities; coordinate with regional coordinators and nodal officers.
· Resolve pending cases within defined timelines.
· Track all raised queries and ensure timely closure.
· Coordinate with Medical Records, Billing, Nursing, and Consultants for submission of required documents.
· Minimize claim rejections arising from incomplete or delayed query responses.
· Match received payments against submitted claims and identify short payments.
· Process supplementary claims wherever applicable.
· Coordinate with the Finance team for accurate accounting entries.
· Verify completeness of discharge summaries, investigation reports, approvals, and supporting documents prior to claim submission.
· Maintain claim records in compliance with applicable scheme guidelines and audit requirements.
· Coordinate with CGHS offices, ECHS regional centres, Ayushman Bharat authorities, Railways, ESI offices, and other empaneled agencies for query resolution and payment follow-up.
· Visit government offices, panel authorities as required to expedite payments and resolve collection issues.
· Coordinate with Billing, Finance, MRD, Nursing, and Operations teams to resolve discrepancies and ensure timely bill and deficiency closure.
· Prepare daily and weekly reports on collections, outstanding receivables, and query status for review by the Billing Head.
· Provide back-up support to the billing team during peak workload periods.
Pay: ₹25,000.00 - ₹40,000.00 per month
Work Location: In person
