Walk-in || CGHS/ EHS Executive

Yashoda Hospitals is looking for a detail-oriented CGHS & EHS Executive to manage billing, claim documentation, and bill submission for patients covered under the Central Government Health Scheme (CGHS) and Employees' Health Scheme (EHS). The candidate will be responsible for verifying documents, preparing and submitting claims, coordinating with concerned authorities, and ensuring timely processing of bills and reimbursement claims.

Key Responsibilities

• Handle CGHS and EHS patient billing, claim preparation, and bill submission.
• Verify patient eligibility, referral letters, approvals, prescriptions, investigation reports, and treatment records.
• Prepare and scrutinize bills according to applicable CGHS/EHS guidelines, package rates, and hospital procedures.
• Ensure accurate documentation and timely submission of claims to the concerned authorities.
• Coordinate with CGHS/EHS departments regarding bill clarifications, queries, objections, and claim rejections.
• Follow up on pending claims, outstanding bills, and reimbursement status.
• Coordinate with admissions, medical records, doctors, pharmacy, and other departments to collect required documents.
• Identify billing discrepancies and ensure corrections before final submission.
• Maintain records of submitted bills, pending claims, rejected claims, and payment status.
• Ensure compliance with scheme guidelines, hospital policies, and billing procedures.
• Support claim reconciliation and documentation during audits.

Qualifications

• Any Graduate; preferably B.Com, BBA, or a related field.
• Knowledge of hospital billing and government healthcare schemes is preferred.
• Basic computer skills and proficiency in MS Excel.

Experience

• 1 to 5 years of experience in hospital billing, credit billing, or government scheme billing preferred.
• Experience in CGHS, EHS, TPA, or insurance billing will be an added advantage.