TPA/ Ayushman Billing Executive

Mukat Hospital & Heart Institute is seeking a skilled and experienced Hospital Billing Executive to join our team. The ideal candidate will have a strong background in healthcare billing, particularly in handling TPA, CGHS, ESI, Ayushman Bharat, credit & cash billing. If you have solid expertise in hospital billing processes and are well-versed in TPA and Ayushman Bharat guidelines, we encourage you to apply and become a valued part of our team.

• Coordinate with insurance companies and TPAs for pre-authorizations, approvals, and claim settlements.
• Collect and verify insurance documentation from patients.
• Submit pre-authorization requests and follow up on approvals.
• Prepare and submit final bills with supporting documents to TPAs.
• Maintain updated records of TPA empanelments, policies, and tariffs.
• Liaise with the finance department for reconciliation of TPA payments.
• Register eligible beneficiaries under Ayushman Bharat using the BIS portal.
• Verify patient documents and eligibility as per government guidelines.
• Process e-card issuance and beneficiary identification.
• Submit pre-authorization requests on the Ayushman Bharat portal.
• Ensure proper documentation and timely upload of treatment and discharge summaries.
• Generate and submit claims through TMS (Transaction Management System).
• Coordinate audits and inspections related to Ayushman Bharat.
• Ensure compliance with NHAB protocols and reporting standard
• 1–3 years of experience in hospital billing, insurance processing, or TPA coordination.
• Familiarity with Ayushman Bharat guidelines, BIS & TMS portals.
• Strong communication and coordination skills.
• Attention to detail and ability to handle multiple cases simultaneously.
• Proficiency in MS Office and billing software.

Job Type: Full-time

Schedule:

• Day shift

Work Location: In person