Job Overview
To ensure complete and accurate revenue capture by conducting daily audits of patient services, clinical documentation, and billing records. The role is responsible for identifying missed charges, preventing revenue leakage, ensuring compliance with hospital tariffs, and improving charge capture processes across all clinical and support departments.
Key Responsibilities
- Daily Revenue Assurance Audit
- Conduct daily audits of IPD, ICU, HDU, OT, Emergency, and ward patient records to ensure all services rendered are accurately billed.
- Verify bedside procedures, nursing procedures, doctor visits, consultant rounds, and clinical interventions against the patient bill.
- Check routine and special services such as ABG, blood sugar monitoring, ECG, nebulization, oxygen therapy, injections, dressing, catheterization, and other chargeable procedures.
- Ensure all consumables, implants, medicines, investigations, and procedures are correctly posted in the Hospital Information System (HIS).
- Verify doctor's orders, nursing notes, treatment sheets, OT records, and procedure documentation with actual bill postings.
- Operation Theatre (OT) & Procedure Audit
- Audit OT schedules, surgery records, anesthesia records, operation notes, implants, consumables, and procedure charges.
- Verify surgeon, anesthetist, assistant surgeon, and OT utilization charges are billed as per approved tariff.
- Ensure packages, exclusions, and additional chargeable items are applied correctly.
- Revenue Leakage Identification & Correction
- Identify missing, under-billed, duplicated, or incorrect charges and initiate timely correction before patient discharge.
- Prepare daily missed charge reports and coordinate with nursing, doctors, OT, pharmacy, laboratory, and billing teams for corrective action.
- Monitor high-risk revenue leakage areas and recommend process improvements.
- Documentation & Compliance Audit
- Ensure all chargeable services are supported with proper clinical documentation and doctor's orders.
- Verify compliance with hospital billing policies, SOPs, and payer requirements.
- Maintain audit trails, discrepancy reports, and revenue assurance MIS.
- Coordination & Reporting
- Coordinate with nursing departments, clinicians, billing, OT, laboratory, radiology, and other support services to resolve billing discrepancies.
- Generate daily, weekly, and monthly revenue leakage reports with trend analysis and corrective action plans.
- Support management during internal and external revenue audits.
Required Skills & Knowledge
- Strong knowledge of hospital billing processes, charge capture, tariffs, packages, and revenue cycle management.
- Understanding of IPD, ICU, OT, Emergency, laboratory, radiology, pharmacy, and nursing workflows.
- Hands-on experience with Hospital Information System (HIS), EMR, and MS Excel.
- Strong analytical, auditing, and problem-solving skills.
- Good communication and interdepartmental coordination abilities.
Qualification & Experience
- Graduate/Post Graduate
- Minimum 7-8 years of experience in hospital billing, revenue assurance, medical audit, or internal audit in a multi-super specialty hospital.
Key Performance Indicators (KPIs)
- Reduction in revenue leakage and missed charges.
- Daily closure of identified billing discrepancies.
- Percentage of patient files audited before discharge.
- Accuracy of charge capture across clinical departments.
- Timely submission of revenue assurance MIS and audit reports.
Remuneration: As per industry standards
Why Join Us: At Sant Nirankari Health City, we offer a collaborative and supportive work environment where your contributions are valued and recognized. Join us in our mission to deliver exceptional healthcare services while upholding the highest standards of quality and patient care.
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