Careers

Job Title: Executive

Job Category:  Billing and Insurance

Job Requirement:

Key Responsibilities

• Receive payment from all patients for the hospital services provided.
• Submit all related documents like reports, bills and discharge summary to concerned internal departments for final approval and settlement
• Process all insurance TPA’s and resolve their queries (TPA’s as well as patients) to get the approval for payment clearance.
• Coordinating with TPA Network team regarding reconciliation, billing queries like, over billing justification/ PPN Package issues & resolving.
• Ensure transactions are correctly recorded of IPD functions also maintaining the records & register for IPD.
• To check the accuracy of the bills on daily basis, before the same could be circulated to the patients/attendants.
• Responsible generation of daily reports & submitting the same to the manager.
• Responsible for cash & credit billing (Insurance) for in-patient department.
• Explaining the cash / TPA (Third Party Administration) insurance package to the patients and initiating backend process by sending all the insurance documents to the respected TPA’s for the final settlement.
• Daily checking the insurance patients and discuss with their consultants about their treatments & stay of hospitalization.
• Daily Updating of Hospital Inpatient, census for pending payments, cashless/ approval status in TPA cases.
• Responsible for maintaining all TPA’s (Third Party Administrator) data and MIS.
• To maintain a good relationship with TPA’s for smooth functioning of the department.
• Interact with all the internal and external auditors and answer queries if any.
• Ensure all the documents are filled as per audit requirement and shared with the respective departments on a timely basis.
• Ensure timely resolution of patient queries (discounts/ billing/ packages etc.) and counsel them on insurance related matters if any.
• To co-ordinate with other departments like Pharmacy, OT Stores & Materials Stores for smooth flow of discharge process.
• To interact with cross function teams to receive/ share updates timely
• Any other portfolio that may be entrusted by the management from time to time.

Required Skills & Qualifications

• 4-5 years of experience in Billing Department.
• Good communication and interpersonal skills
• Accurate processing of information both verbal and written
• Demonstrates high attention to detail with ability to solve problems on hand
• Should demonstrate patience and confidence when dealing with customer enquiries and complaints
• Strong attention to details

Educational Qualifications: B.com/ MBA

Expected Deliverables

• Ensuring zero billing discrepancies
• Accurate filing and maintenance of bills (online and offline)
• Timely processing of insurance claims with TPA’s
• 100% compliance to statutory and internal audits
• Resolving customer queries and ensure zero escalations

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Job Description: Assistant Manager- Business Development

Job Requirement: Candidate should have knowledge of the areas listed below

Business / Financial Responsibilities

• To achieve set targets by ensuring referral conversions and leads generated from consultants and empaneled doctors.
• Handling the assigned territory and generating revenue through in-person meetings, and promotional events and regular follow –up with doctors.
• Ensuring ROI of events by acquiring new patient registrations at each of the assigned Units.
• To generate patient’s footfall in hospital
• Provide market feedback through market research and competitor analysis
• Identifying, liaising and establishing alliances with sources like hospitals, doctors, clinics for bringing in more business.

Operational Responsibilities and Key Tasks

• To come up with weekly and monthly target plan and ensure implementation of the same.
• Responsible for organizing and managing different local events, health camps and other branding opportunities.
• Tracking competitor activities on field.
• To have constant interaction with new consultants and doctors and brief about the facilities available and quality of service.
• To share weekly and monthly status reports and other essential documents to the concerned officials
• To search new potential areas for business development

Customers

• To retain the clients (doctors) by constant follow-up and ensuring good service
• Ensuring interim and repeat business by educating on various benefits and cross functional opportunities
• To ensure the right doctors selection and accurate brand matrix
• Building & maintaining relationships with referring doctors and solve any concerns expressed.
• Ensuring strong support for all referrals product to the hospital.
• Acting as the link between the patients, doctor and the organization.

People

• To liaise with cross functional teams and share accurate information of referral doctors and their requirements
• To collaborate with teams from other units and discuss on the new BD opportunities

Work Experience:

• 5 + Years of experience. Preferable work experience from hospital
• Good Communication skill
• Ability and interest on learning the job
• Excellent interpersonal skill
• Relationship Management
• Target oriented

Expected Deliverables:

• Generating business from private practising Doctors
• Carrying out various business promotional activities to meet the individual targets
• Expansion of referral doctor base to the hospital.
• Ensuring after sale support with the referring doctors.

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Job Requirement:

• To give psychological support to the patients in all kind of situations.
• Maintains a cooperative relationship among health care teams by communicating information, responding to requests and building rapport with them
• Diagnosing the disease by analysing patient’s symptoms and taking required actions for his/her recovery in consultation with doctor.
• To provide individual nursing care for each patient according to their needs.
• Educate patients and families regarding breast feeding, newborn care, C-Section care etc.
• Sterilizing Instruments: One of the primary preoperative duties is to ensure that all surgical instruments are properly sterilized and ready for use. This step is crucial in preventing infections and maintaining a sterile environment in the OR.
• Preparing the Operating Room: Scrub nurses help set up the OR by arranging surgical instruments, drapes, and other necessary equipment. They must ensure that everything is in its proper place and easily accessible to the surgeon.
• Verifying Patient Information: Scrub nurses work closely with the surgical team to verify patient information, including the procedure to be performed and the surgical site. This step is essential to avoid any mistakes and ensure patient safety.
• Assisting with Patient Positioning: Scrub nurses may assist in positioning the patient on the operating table to ensure that the surgical site is accessible and that the patient is comfortable.
• Maintaining Sterility: The scrub nurse’s primary responsibility during surgery is to maintain a sterile field. They must ensure that no unsterile objects or personnel come into contact with the surgical site.
• Handling Instruments: Scrub nurses are responsible for passing surgical instruments to the surgeon and other members of the surgical team. They must know the names and functions of a wide range of instruments and be able to anticipate the surgeon’s needs.
• Counting Instruments and Sponges: To prevent surgical errors, scrub nurses keep a precise count of all instruments, sponges, and other materials used during the procedure. This count is confirmed at the beginning and end of the surgery.
• Monitoring the Surgical Field: Scrub nurses closely monitor the surgical field, watching for any signs of contamination or complications. They may also be required to suction blood or other fluids to keep the area clear for the surgeon.
• Cleaning and Sterilizing Instruments: Scrub nurses are responsible for cleaning and sterilizing the instruments used during surgery. They must follow strict protocols to ensure that all equipment is properly disinfected and ready for the next procedure.
• Documenting the Procedure: Scrub nurses assist in documenting the details of the surgery, including the instruments used, the duration of the procedure, and any complications that occurred. Accurate documentation is essential for patient records and legal purposes.
• Assisting in Patient Transfer: Scrub nurses may help transfer the patient from the operating table to the recovery area, ensuring that the patient is stable and comfortable.

Educational Qualifications:

• General Nursing/ B.Sc Nursing

Work Experience:

• 1-5 years of experience as an Staff Nurse
• Good communication and interpersonal skills
• Sound understanding of the organization services and packages
• Caring and compassionate nature

Expected Deliverables:

• Creating positive experience for the patients
• Updation of documents and duty books in a timely manner
• Resolution of issues and concerns

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Job Requirement:

Financial/ Business

• Explain hospital services to every walk-in and registered patient and ensure conversions
• Implementation of clinical and administrative protocols & procedures.
• Act as a SPOC (Single point of contact) to ensure proper deliverables to clients and to maintain long lasting relationships with them

People

• To foster peer support; provide training to others regarding the hospital wide policies and processes.
• To extend support and coordinate services in line with the Clinical Team’s & Nursing Team’s requirement.
• To constantly interact with respective departments to negotiate and expedite scheduling and completion of tests, procedures, and consultations.
• Coordinating with Credit Helpdesk/Billing Team for credit patients and updating the patients/patient family members regarding their approval status at periodic interval.

Customer

• To achieve 90% and above score in patient satisfaction index on a monthly basis.
• Investigate and resolved customer inquiries and complaints in a timely and empathetic manner
• To make inpatient rounds, ask open-ended questions to assess patient needs and ensure the services provided delight the patient and patient family members.
• Provide prompt, courteous, efficient and personalized service to all patients.

Operations

• Giving correct information to the clients about the services provided by the hospital
• Basic first level of counselling for correct appointments.
• Giving appointments to patients/ rescheduling it, if required.
• Proper handing over the duty to next duty staff and documenting it in the register.
• Responsible for all the equipment’s/gadgets etc. used at reception & waiting area.
• Informing the concerned department person if any problem faced.
• Ensuring that daily newspaper & weekly magazines etc. are kept properly in waiting area.
• Responsible for keeping their working areas neat & clean all the time.
• To keep themselves updated about hospital & its activities.
• Informing in-charge about any untoward incident immediately, if any.
• Handling the responsibilities as & when given by in-charge/ managers.
• Proper registration of new & revisit patients. Adding correct and completed information in the software.
• Issuing pt. ID card to all new patients.
• Accurate billing & handing over billing receipts to patients/party.
• Answering patient queries regarding bills, hospital services if any.
• Proper counselling of patients at the time of admission, discharge.
• Taking patient consent at the time of admission-on-admission form & countersigning the document.
• Providing labels in OP & IP files.
• Meeting admitted patients/ party with provisional bill and collecting advance amount from all admitted patients.
• Checking billing sheet of admitted patients and keeping final discharge bill ready, communicating to patient/party about the detailed bill and collecting final bill payment.
• Maintaining petty cash and related documents.
• To keep themselves updated about hospital & its activities.
• To contact right person in case of any doubts for clarifications.
• Informing in-charge about any untoward incident immediately, if any.
• Responsible for all other principal duties and key tasks assigned by the management from time to time.

Educational Qualifications:

Any Degree

Work Experience:

• 1-4 years of experience as an GRE in Health Care Industry
• Should be a good listener and exceptional in people management.
• Good in Attitude & Analytical skills

Expected Deliverables:

• Ensure patient delight
• Execute the SOP as per the guidelines
• Inculcating the culture of cohesiveness.

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Responsibilities:

• To ensure delivery of patient care through implementation of prescribed medication and monitoring effects.
• To provide nursing care to patients based on established clinical practice standards.
• To collaborate with other disciplines to ensure effective and efficient patient care delivery.
• To actively participate in programs for quality improvement in nursing practices.
• To maintain positive interpersonal relations with staff.
• To promote a safe environment for patients, visitors and coworkers including the implementation of infection control policies of the hospital.
• Smooth handover of the shift responsibilities, by briefing and updating on the patients’ health conditions and medication intakes.
• To administer medicines and injections according to the time stated on their charts and ensure that all dietary requirements are followed by the patient.
• Preparing rooms and decontaminating equipment’s and instruments.
• Responsible for maintaining patient’s documents, reports, charts and duty books
• Statutory Compliances
• Others related to finance and accounts
• Ensure compliance with prescribed standards of practice

Most Important Demands

• Core Competencies
• Service Excellence
• Team Player
• Technical Competencies
• Basic Life Support Certification.
• Reasonable content knowledge
• Good knowledge of nursing practices.
• Computer literate

Behavioral/Leadership Competencies

• Alertness + prompt in response + action.
• Caring
• Empathetic
• Education/Experience
• Responsible for all other principal duties and key tasks assigned by the management from time to time

Certificates and Licenses:

• Statutory Registrations – Karnataka Nursing Registration

Work Experience:

• 2 to 5 years of experience

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