Job Purpose

Responsible for overseeing all billing and claims operations across Bliss Healthcare Limited to ensure accurate, timely, and compliant invoice verification, claims submission, recon- ciliation, and reporting.

This role drives revenue cycle efficiency, minimizes deduc- tions, ensures adherence to payer requirements, and leads the billing & claims team to achieve set KPIs.

Key Responsibilities

Lead and supervise all billing and claims activities to ensure 100% invoice receipt, verification, and error-free claim submission.

Oversee invoice checks to confirm:

Invoice number matches smart, Slade, or m-Tiba report. Member number matches across reports and invoice. Amount matches report totals. Correct claim form is used.

Dates and patient names match across all documents. Ensure 100% reconciliation of all insurance accounts.

Monitor and achieve KPI targets for the team

95% account sign-off by revenue.

<1% deduction rate.

Monitor timely submissions from unit HQ payer.

Ensure all visits are Smarted/LCT and all documents uploaded on Slade.

Develop, maintain, and implement billing SOPs in alignment with payer requirements.

Provide regular training to team members and medical center staff on scheme changes and claims processes. Ensure communication of pending and queried billings to insurers and relevant teams promptly.

Submit accurate and timely reports, including real-time system updates with IT teams.

Collaborate with operations, finance, and clinical teams to resolve claim disputes, rejections, and delayed payments. Ensure timely statement generation and submission to insurers.

Lead initiatives to improve clean claim rates and reduce processing delays.

Any other duties assigned by the supervisor(s).

Job Requirements

Minimum Qualifications

Bachelor's degree in Finance, Accounting, Healthcare Administration, or related field.

Experience

Minimum 5 years' experience in healthcare billing and claims, with at least 2 years in a supervisory role.

Strong knowledge of medical billing systems (e.g., Slade, m-Tiba) and payer claim processes.

Experience in hospital or clinical revenue cycle management added advantage.