Job Description – Billing & Insurance Incharge
Location: Shimoga, Karnataka
Department: Billing & Insurance
Reporting To: Hospital Administrator / Finance Manager
Shift: Rotational Shifts (Morning, Evening & General as per hospital requirements)
Position Summary
The Billing & Insurance Incharge is responsible for managing hospital billing operations, insurance and TPA claims processing, cashless approvals, revenue collection, and patient billing services. The role ensures accurate billing, timely claim submissions, and compliance with hospital and insurance guidelines.
Key ResponsibilitiesBilling Operations
- Supervise OPD, IPD, emergency, pharmacy, and diagnostic billing activities.
- Ensure accurate and timely generation of patient bills and invoices.
- Verify charges, procedures, and service entries before final billing.
- Coordinate with clinical and support departments to avoid billing discrepancies.
- Monitor daily billing collections and revenue reports.
Insurance & TPA Management
- Handle cashless approvals, pre-authorizations, and claim submissions.
- Coordinate with insurance companies and TPAs for claim processing.
- Follow up on pending approvals, queries, denials, and settlements.
- Maintain complete documentation for insurance claims and reimbursements.
- Ensure timely reconciliation of insurance payments.
Team Management
- Supervise billing executives and front-office billing staff.
- Allocate work, monitor performance, and provide training.
- Ensure adherence to billing SOPs and hospital policies.
- Resolve escalated patient and insurance-related issues.
Reporting & Compliance
- Prepare daily, weekly, and monthly MIS reports.
- Monitor billing accuracy and revenue leakage.
- Support internal and external audits.
- Ensure compliance with hospital policies, insurance regulations, and data confidentiality standards.
Patient Coordination
- Guide patients and attendants regarding insurance procedures and required documentation.
- Explain billing details, approvals, and payment processes.
- Address billing and insurance-related queries professionally.
Qualification
- Bachelor's Degree in Commerce, Business Administration, Healthcare Management, or related field.
- Certification in Medical Billing or Health Insurance will be an added advantage.
Experience
- 3–6 years of experience in hospital billing, insurance, or TPA operations.
- Experience in handling cashless claims, reimbursements, and hospital billing software.
Required Skills
- Knowledge of hospital billing procedures and revenue cycle management.
- Understanding of TPA and insurance claim processes.
- Strong analytical and reconciliation skills.
- Good communication and patient-handling abilities.
- Proficiency in MS Office and Hospital Information Systems (HIS).
- Ability to work in rotational shifts and manage team operations effectively.
Work Location: In person
