Billing and Insurance Desk Executive job description
A Billing and Insurance Desk Executive prepares patient bills, handles cashless and reimbursement claims and follows up with insurers. The role protects the hospital or clinic's income and spares patients confusion at discharge.
Why the role exists
Hospitals and larger clinics in India deal with cash patients, corporate tie-ups and insurers or TPAs. The billing desk turns treatment records into accurate bills and claim files. Errors here cause disputes with patients and delayed or rejected claims, so the role needs care and steady follow-up.
What the person does
- Prepare patient bills from treatment, pharmacy, lab and room records and check them before issue.
- Explain charges, advances and package inclusions to patients and families in simple language.
- Raise pre-authorisation requests and send claim documents to insurers and TPAs.
- Track claim status daily and respond to queries, shortfalls and rejections within the insurer's timeline.
- Reconcile cash, card and UPI collections with the daily report and hand over to accounts.
- Maintain tie-up rate lists for corporates and insurers and apply them correctly.
- Keep a list of pending and delayed claims and escalate old ones to the manager.
- Store bills, discharge summaries and claim files in an orderly way for audit.
Skills and tools
- Hospital billing systems and clinic software
- Knowledge of cashless claim flow, pre-authorisation and TPA portals
- Reading discharge summaries and treatment sheets accurately
- Excel for claim trackers and reconciliation
- Clear communication with patients, insurers and doctors
- Attention to detail with codes, packages and rate lists
- Handling cash, card and UPI collections
- Patience in follow-up and documentation
Education and experience
Preferred, never a bar: equivalent experience counts.
- Graduate in commerce, healthcare administration or a related field is preferred, or equivalent experience.
- Preferred experience of one or more years in hospital billing, insurance desk or TPA coordination.
- Working knowledge of Excel and billing software is preferred, or equivalent experience.
- Familiarity with insurer processes helps, though requirements depend on the employer and its panel.
How the work is judged
- Accuracy of bills and fewer disputes at discharge
- Share of claims submitted complete and without avoidable queries
- Speed of follow-up on pending, short-paid and rejected claims
- Daily reconciliation of collections with the accounts team
- Clarity of records for audit and insurer reviews
Where the role can lead
- Senior billing executive or insurance desk lead
- Revenue cycle or accounts roles in a hospital or clinic group
- Healthcare operations or claims analyst roles after added experience
Interview questions to ask
Ask every candidate the same questions in the same order and score them against written anchors, so the decision rests on the work and not the impression.
- Walk us through the steps from admission to final claim settlement for a cashless patient.
- A claim is short-paid by the TPA. How do you find out why and what do you do?
- How would you explain a large bill to a worried family without raising the tension?
- What checks do you make before sending a claim file?
- Tell us about a billing mistake you caught and how you corrected it.
- How do you keep track of fifty pending claims without losing any?
Hiring tips for this role
- Give a sample bill and discharge summary and ask the candidate to spot errors or missing items.
- Check which insurer and TPA portals they have used. Experience with your common panel partners saves weeks of training.
- Ask about rejected claims. Strong candidates describe the cause and the follow-up, not only the outcome.
- Look for patient manners too. A billing desk meets families at a stressful time, and tone matters.
Questions about hiring a billing and insurance desk executive
A billing executive prepares and issues bills. An insurance desk executive handles pre-authorisations, claim files and insurer follow-up. In smaller hospitals one person often does both, so list the tasks in the job description.
Missed charges, wrong package application, incomplete documents and late follow-up on short-paid claims. A checklist before issue and a weekly review of pending claims reduce most of these.
Basic familiarity with procedures, diagnoses and terms helps in reading summaries. Deep clinical knowledge is not required. What matters is accuracy, patience and knowing what each insurer needs.
GullyHR offers permanent talent acquisition. We agree the job description with you, find and screen candidates with hospital billing or claim experience, and support the offer. Your accounts head can run the final test.
Hiring a billing and insurance desk executive?
GullyHR runs talent acquisition for permanent roles. We agree the job description with you, find and screen candidates against it, and support the offer through to joining. We recruit permanent employees. We do not supply contract or temporary staff.