IP Billing &Insurance

• Billing Operations Management
• Supervise and manage OP & IP billing teams.
• Ensure accurate and timely generation of patient bills.
• Monitor daily billing activities, reconciliations, and cash collection.
• Validate service coding (ICD/CPT) and pricing in accordance with policies.
• Generate and present daily, weekly, and monthly collection reports to senior leadership.
• Analyze aging reports, highlight trends, and propose corrective actions.
• Insurance Coordination & Claims Processing
• Oversee pre-authorization, insurance eligibility verification, and approvals.
• Supervise submission of insurance claims and monitor turnaround times.
• Follow up on pending claims and coordinate with insurers for settlement.
• Address claim rejections, denials, and initiate appeals as necessary.
• Compliance & Documentation
• Ensure compliance with medical billing regulations and insurer requirements.
• Maintain accurate documentation of billing and insurance communications.
• Stay updated with changes in insurance guidelines and tariff revisions.
• Team Management
• Lead and train billing and insurance team members.
• Conduct regular performance reviews and feedback sessions.
• Allocate work schedules and ensure staffing coverage.
• Reporting & Audit
• Generate and analyze daily/weekly/monthly billing and collection reports.
• Support internal and external audits by providing necessary documentation.
• Monitor KPIs such as billing accuracy, claim rejection rate, and AR days.
• Maintain complete documentation of communication and collection efforts.
• Regularly review and update SOPs to reflect current best practices.
• Stakeholder Coordination
• Liaise with clinicians, patient service departments, and finance teams.
• Address patient concerns related to billing or insurance coverage.
  
  

Coordinate with TPA/insurance representatives for seamless operations.

Qualifications

B.com,BBA,Any graduation

Must have skills

• Passion for Excellence
• Results Orientation
• Communication Skills
• Customer Focus
  
  

Good to have skills

• Building Relationships
• Leadership & Influencing
• Problem Solving and Decision Making