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