Group Billing Manager

Role & responsibilities

To lead and standardise billing, collection, Schedule of Charges governance and revenue assurance across all hospital units. The role will ensure market aligned pricing, accurate billing, controlled SOC revision, complete implementation and continuous post execution monitoring.

Key Responsibilities

Billing Operations and Revenue Assurance

• Manage OPD, IPD, Emergency, diagnostic, pharmacy, procedure and package billing across all units.
• Audit bills against orders, services, approved tariffs and packages and close omissions or deviations.
• Ensure adequate counter coverage, interim billing, deposit follow up and timely final billing.

SOC Market Analysis and Benchmarking

• Conduct periodic market analysis of the Schedule of Charges against comparable hospitals and diagnostic providers.
• Analyse specialty demand, competitor pricing, payer reimbursement, package rates, internal service cost, patient affordability and market position.
• Identify underpriced, overpriced, obsolete, duplicated and missing charge codes and quantify revenue and patient impact.
• Maintain a documented benchmark report and recommended pricing range for management review.

SOC Updation and Revision Governance

• Coordinate proposed SOC changes with Centre Heads, Finance, Medical Administration, consultants, TPA and management.
• Prepare a change note stating the existing rate, proposed rate, justification, expected financial impact and effective date.
• Ensure every addition, deletion, revision, package change and exception receives approval under the authority matrix.
• Maintain version control, approval history, effective dates and one authorised master SOC for the group.

SOC Execution and HIMS Implementation

• Coordinate authorised SOC upload in HIMS across all units and map codes to departments, packages and payer categories.
• Test sample bills, packages, discounts, taxes where applicable, estimates and reports before go live.
• Communicate approved revisions to billing, TPA, corporate, Finance, Centre Heads and affected departments.
• Train users, withdraw superseded rate sheets and ensure the revised SOC is applied from the approved effective date.

SOC Monitoring and Post Implementation Audit

• Monitor actual rate application, realisation, discount trends, patient queries, payer deductions and revenue movement after revision.
• Audit unit wise compliance and investigate old rates, manual overrides, wrong code mapping and unauthorised deviations.
• Submit post implementation variance and benefit reports and recommend corrective revision where necessary.

Collection and Financial Controls

• Reconcile HIMS with cash, POS, UPI, bank transfers and receipts and document cashier handover.
• Control discounts, refunds, corrections, cancellations and credit notes through the authority matrix.
• Escalate unexplained variance, suspected fraud and unauthorised master changes immediately.

Patient Service Team and MIS

• Ensure itemised bill explanation and timely resolution of billing complaints and disputes.

Train billing teams and submit consolidated MIS on SOC compliance, collections, leakage, turnaround time and CAPA.

Preferred candidate profile

• BCom, MCom, MBA Finance, MHA, MBA Hospital Management or equivalent qualification.
• Preferably 7 to 10 years of hospital billing or revenue cycle experience, including 3 years in management.
• Demonstrated experience in tariff or SOC benchmarking, revision, HIMS master configuration and post implementation audit.
• Strong knowledge of packages, TPA and scheme billing, reconciliation, Excel and multi unit billing controls.

Overall Accountability

The Group Billing Manager will own the complete SOC lifecycle from market study and management approval to HIMS execution and post implementation monitoring. No tariff change, billing variance or revenue exception should remain unauthorised, unexplained or unassigned.