Billing Manager

Job Summary

The Billing Head will be responsible for managing the complete billing function of the hospital unit, ensuring accurate and timely billing, effective coordination with internal departments and TPAs/government schemes, and strong control over revenue realization and billing processes.

Key Responsibilities

• Lead and manage the overall hospital billing operations for the unit.
• Ensure accurate and timely billing for IPD, OPD, daycare and other hospital services.
• Manage billing under TPA, CGHS, ECHS, PMJAY, RGHS and other government/corporate schemes.
• Ensure proper documentation, authorization, package applicability and tariff adherence.
• Monitor billing errors, deductions, rejections and pending bills and take corrective actions.
• Coordinate with Insurance/TPA, Corporate, Government Scheme and Finance teams for timely claim submission and settlement.
• Monitor unbilled revenue, outstanding bills and revenue leakage.
• Ensure compliance with approved hospital tariffs, packages, discounts and billing policies.
• Conduct regular billing audits and identify process gaps and revenue leakage.
• Prepare and review billing MIS and performance reports for management.
• Lead, train and monitor the billing team to ensure efficiency and service quality.
• Coordinate with Clinical, Nursing, Pharmacy, Diagnostics, Front Office and Finance teams for smooth billing operations.
• Handle and resolve billing-related patient queries, escalations and disputes.
• Ensure adherence to hospital policies, statutory requirements and internal controls.
• Drive process improvement and automation initiatives within the billing function.

Key Skills

• Strong knowledge of Hospital Billing & Revenue Cycle Management
• Expertise in TPA / CGHS / ECHS / PMJAY / RGHS billing
• Strong understanding of hospital tariffs, packages and insurance processes
• Billing audit and revenue leakage control
• Team leadership and people management
• Strong analytical and MIS skills
• Good communication and stakeholder-management skills.