Billing Executive

Company Description Gyanindit Pvt. Ltd. is a knowledge-driven organization focused on empowering individuals and organizations through expert services and guidance. Inspired by the motto "Encouraging Empowerment," the company supports people in achieving their professional and personal goals. Gyanindit envisions a world where everyone has access to the tools, knowledge, and support needed to succeed. Its mission centers on providing tailored resources and solutions that help optimize organizational performance and leverage technology for innovation.

Job Title: Billing Executive

Department: Billing & Accounts

Reports To: Accounts Head / Facility Manager / CEO

Location: Hauz Khas, Delhi (Cancer Centre / Day Care Oncology Setup)

Employment Type: Full-time

Notice Period : Immediate joiner / 15 days

CTC: Rs.27000 in hand per month ( depending on experience )

Job Purpose

The Billing Executive is responsible for accurate, compliant, and timely billing of all patient services provided at the cancer centre. This includes cash billing, insurance/TPA billing, package billing, coordination with clinical teams, and ensuring zero revenue leakage while maintaining transparency and ethical billing practices.

Key Responsibilities

1. Patient Billing Operations

• Generate accurate bills for OPD, daycare chemotherapy, immunotherapy, targeted therapy, supportive care, procedures, investigations, and pharmacy items.
• Ensure correct mapping of services, consumables, drugs, and professional charges as per approved rate lists.
• Prepare interim, final, and discharge bills as applicable.
• Explain bills clearly to patients/attendants and address billing-related queries politely and professionally.

2. Insurance, TPA & Corporate Billing

• Verify insurance eligibility, policy coverage, sub-limits, exclusions, and waiting periods.
• Coordinate pre-authorization requests with TPAs/insurance companies, including documentation and timely follow-ups.
• Ensure billing strictly adheres to approved GIPSA/TPA rate lists and negotiated corporate rates.
• Prepare and submit claims with complete documentation within defined TAT.
• Track claim status, respond to queries, and follow up for approvals, enhancements, and settlements.
• Identify discrepancies in settlement letters and escalate for resolution.
• 3. Cash & Credit Management
• Collect payments via cash, card, UPI, bank transfer, or cheque as per hospital policy.
• Issue receipts and ensure proper daily cash reconciliation.
• Coordinate with accounts for deposit of collections and daily MIS reporting.
• Maintain transparency and prevent underbilling, overbilling, or duplication of charges.

4. Coordination with Clinical & Support Teams

• Coordinate closely with doctors, nurses, pharmacy, lab, and front desk to ensure all billable services are captured.
• Validate chemotherapy protocols, drug dosages, cycles, and consumables before billing.
• Ensure real-time updates of additional orders or changes in treatment plans.

5. Documentation & Compliance

• Maintain complete patient billing files (physical and/or digital) with consent forms, approvals, case sheets, and investigation reports.
• Ensure compliance with NABH standards (if applicable), insurance norms, and internal SOPs.
• Maintain confidentiality of patient data as per ethical and legal requirements.

6. Reporting & MIS

• Prepare daily billing reports, collection summaries, pending approvals, and outstanding claims.
• Maintain aging reports for receivables and follow up for timely recovery.
• Share monthly billing performance data with management.

7. Audit & Process Improvement

• Support internal and external audits related to billing and insurance claims.
• Identify revenue leakages, process gaps, or recurring claim rejections.
• Suggest improvements in billing workflows and documentation.

Skills & Competencies

Technical Skills

• Strong knowledge of hospital billing processes, insurance, TPAs, and oncology-specific billing.
• Familiarity with GIPSA rates, CGHS (preferred), and corporate health insurance processes.
• Proficiency in hospital management systems (HIS), MS Excel, and basic accounting software.

Behavioral Skills

• High attention to detail and accuracy.
• Ethical mindset and integrity in financial dealings.
• Good communication skills (Hindi & English; local language preferred).
• Ability to handle sensitive patient interactions with empathy.
• Ability to work under pressure and manage multiple cases simultaneously.

Educational Qualifications

• Graduate in Commerce / Business Administration / Healthcare Management (preferred).
• Diploma or certification in Medical Billing / Hospital Administration is an added advantage.

Experience Requirements

• 1–5 years of experience in hospital or healthcare billing.
• Prior experience in oncology, day care centres, or insurance-heavy setups preferred.

Key Performance Indicators (KPIs)

• Accuracy of billing (minimal errors or rework).
• Timely submission and settlement of insurance claims.
• Reduction in claim rejections and discrepancies.
• Daily cash and billing reconciliation accuracy.
• Patient satisfaction related to billing clarity.

Working Conditions

• Hospital / cancer centre environment.
• Shift-based work may be required depending on patient load.
• Interaction with patients, attendants, TPAs, insurance companies, and internal teams.

Confidentiality & Ethics Clause

The Billing Executive is expected to maintain strict confidentiality of patient information, financial data, and institutional policies. Any deviation from ethical billing practices may lead to disciplinary action as per organizational policy.