CGHS / EHS Executive

We are looking for a responsible and detail-oriented CGHS / EHS Executive to manage government healthcare scheme patients, billing documentation, claim processing, and coordination with the hospital's billing and medical departments.

The candidate should have knowledge of CGHS (Central Government Health Scheme) and EHS (Employee Health Scheme) procedures, cashless treatment documentation, and reimbursement or claim processing.

Key Responsibilities

• Handle CGHS and EHS patient registration and documentation.
• Verify patient eligibility, beneficiary cards, referrals, and required approvals.
• Coordinate with patients regarding scheme-related formalities.
• Process pre-authorisation requests and treatment approvals as applicable.
• Verify treatment bills, medical records, and supporting documents.
• Prepare and submit CGHS / EHS claims within the prescribed timelines.
• Follow up on pending claims, queries, and payment status.
• Coordinate with doctors, billing staff, medical records, and insurance departments.
• Maintain accurate records of approvals, claims, and scheme-related correspondence.
• Assist with billing as per applicable government scheme rates and hospital policies.
• Respond to queries raised by scheme authorities and help resolve claim discrepancies.
• Ensure compliance with applicable scheme guidelines and hospital procedures.

Job Requirements

• Any degree or relevant qualification; a healthcare administration or commerce background is preferred.
• 1–2 years of experience in hospital billing, government healthcare schemes, or insurance coordination preferred.
• Knowledge of CGHS and EHS procedures and documentation.
• Understanding of pre-authorisation, claim submission, and billing processes.
• Basic computer skills, MS Excel, and hospital management software.
• Good communication, coordination, and documentation skills.
• Ability to maintain accurate records and meet claim submission deadlines.
• Previous experience in a hospital billing or government scheme department will be an advantage.

Skills Required

• CGHS / EHS documentation
• Hospital billing and claim processing
• Patient coordination
• Pre-authorisation and approval follow-up
• Medical records verification
• MS Excel and hospital software
• Communication and problem-solving
• Attention to detail

How to Apply

Interested candidates with relevant hospital experience and knowledge of CGHS / EHS procedures are encouraged to apply with their updated resume.

Job Type: Full-time

Benefits:

• Provident Fund

Work Location: In person