MANISH KUMAR

Permanent Address: Village & post office Bari Tihsil

Father’s Name: Late Shri Dile Ram &District Hamirpur pin-177001(Himachal Pradesh) Marital Status: Married

Children: 2 (1 Daughter & 1 son)

Email id: adnhoe@r.postjobfree.com

Mobile -875*******

Over 18+ years of professional experience in Hospital Billing, Corporate Business/Health Insurance/TPA Management while working with Hospitals.

ACADEMIC QUALIFICATION

M.B.A IN FINANCE VINAYAK MISSION UNIVERISTY

PROFESSIONAL QUALIFICATION

Well Versed in M.S Office, MS Windows 95, 2000, Tally 4.5, 5.4 & Tally 7.2, 9.2 Tally, Busy -B accounting Software . HMS System.

Jobs experience: 18 years

1. Worked with Amcare Hospital as a Head Operation (Since feb -2020 and till date) 2. Worked with Nagar Hospital as a Head Operation (Since Feb. -2020 to Feb. 2021) 3. Worked with Manav hospital as a Operation & Marketing (since feb-2018 to Feb. 2020) 4. Worked with Vipul TPA Pvt ltd as a Networking Manager (Since jan-2017 to Feb. -2018) 5. Worked with Privat hospital as a Billing & TPA Manager (Since Dec-2012 to jan-2017) 6. Worked with Tulip hospital as a Collection Recovery & Business Development Assistant Manager (Since oct-2010 to Nov-2012)

7. Worked with Privat hospital as TPA/ Billing Sr. Executive(Since July-2004 to step -2010) 8. Worked with Asia medical assistant ltd as a Accounts Executive (Since march-2002 to June 2004)

Organization Profile Multi- Super-Specialty Amcare hospital Hospital in Zirkpur( punjab) .

Job Profile – OPERATION HEAD

(Hospital Operations (Non-Clinical) & Administration - General Management of the hospital including Front Office (OP & IP), Housekeeping, Transport, Security, Maintenance, Statutory Licensing, BMW,Laundry, Stores, Ambulance, cafeteria, Billing, TPA, Recovery, Empanelment, Marketing & Hr )

Roles and Responsibilities- Operations Head

Hospital Administration

To ensure smooth working and monitoring the performance of all the departments.

Hospital Operations (Non-Clinical) & Administration - General Management of the hospital including Front Office (OP & IP), Housekeeping, Transport, Security, Maintenance, Statutory Licensing, BMW,Laundry, Stores, Ambulance, cafeteria.

Increasing revenue of the Hospital by increasing numbers of patients in the hospital and increasing third party paying customers of the hospital

Daily rounds and taking care of Department-wise issues

Responsible of End-to-End Business Development for Revenue.

Checking doctors’ appointments and staff on duties.

Monitoring Out-Patient and In-patient collections on daily, weekly, and Monthly basis and reporting to Higher authorities.

Monitoring all the activities relating to patient care and treatment.

Controlling and ensuring that SOPs and Policies are followed without any room for manipulation or avoidance.

Ensuring renewal of all hospital related licenses timely..

Building relationship with other dignitaries in the hospital industry, referral doctors, statutory authorities, government health departments, external agencies etc.

Building relationship & Liasoning with Top Govt. officials.

Ensuring smooth functioning of critical areas such as Operation Theaters, Intensive Care areas, admission, reception, ER by supervising and coordinating with respective departmental heads.

Reporting various reports & MIS to the Corporate periodically.

Addressing patient complaint and responding to the complaint within minimum time.

Liasoning with the outsourced companies for better functioning.

.

Interaction

Conducting periodic meetings and discuss regarding following points

All incidents that have occurred in the hospital recently

Training, problem solving, service recovery (dealing with irate customers etc)

Manpower allocation and addressing other issues in wards.

Meeting with ward managers to get inputs on patients/discharge etc..

Meet with concerned dept HODs to get information on duty rooster for doctors.

Meeting with the consultants of all specialties monthly and addressing their issues.

Attending management meetings and other medical or departmental related committees.

Interaction with Staff members and addressing the staff frequently to maintain personal touch with the personnel.

Dealing with queries of patient's relatives and solving their concerns.

In case of critical matters, meeting with patient & patient's relatives personally. Organization Profile Multi-Specialty Nagar Hospital. Job Profile – OPERATION HEAD

(Hospital Operations (Non-Clinical) & Administration - General Management of the hospital including Front Office (OP & IP), Housekeeping, Transport, Security, Maintenance, Statutory Licensing, BMW,Laundry, Stores, Ambulance, cafeteria, Billing, TPA, Recovery, Empanelment, Marketing )

Roles and Responsibilities- Operations Head

Hospital Administration

To ensure smooth working and monitoring the performance of all the departments.

Hospital Operations (Non-Clinical) & Administration - General Management of the hospital including Front Office (OP & IP), Housekeeping, Transport, Security, Maintenance, Statutory Licensing, BMW,Laundry, Stores, Ambulance, cafeteria.

Increasing revenue of the Hospital by increasing numbers of patients in the hospital and increasing third party paying customers of the hospital

Daily rounds and taking care of Department-wise issues

Responsible of End-to-End Business Development for Revenue.

Checking doctors’ appointments and staff on duties.

Monitoring Out-Patient and In-patient collections on daily, weekly, and Monthly basis and reporting to Higher authorities.

Monitoring all the activities relating to patient care and treatment.

Controlling and ensuring that SOPs and Policies are followed without any room for manipulation or avoidance.

Ensuring renewal of all hospital related licenses timely..

Building relationship with other dignitaries in the hospital industry, referral doctors, statutory authorities, government health departments, external agencies etc.

Building relationship & Liasoning with Top Govt. officials.

Ensuring smooth functioning of critical areas such as Operation Theaters, Intensive Care areas, admission, reception, ER by supervising and coordinating with respective departmental heads.

Reporting various reports & MIS to the Corporate periodically.

Addressing patient complaint and responding to the complaint within minimum time.

Liasoning with the outsourced companies for better functioning.

.

Interaction

Conducting periodic meetings and discuss regarding following points

All incidents that have occurred in the hospital recently

Training, problem solving, service recovery (dealing with irate customers etc)

Manpower allocation and addressing other issues in wards.

Meeting with ward managers to get inputs on patients/discharge etc..

Meet with concerned dept HODs to get information on duty rooster for doctors.

Meeting with the consultants of all specialties monthly and addressing their issues.

Attending management meetings and other medical or departmental related committees.

Interaction with Staff members and addressing the staff frequently to maintain personal touch with the personnel.

Dealing with queries of patient's relatives and solving their concerns.

In case of critical matters, meeting with patient & patient's relatives personally. Revenue, Settlement & Asset Management

Ensure the achievement of the Annual Revenue Target for all specialties.

Targeting activities aimed to generate revenue from Diagnostics and Homecare.

To keep average manpower cost per occupied bed minimum.

Monitoring Income and expenses of nearby OPD.IPD

Managing overall expenses of the units.

Controlling and closely monitoring any activity of Revenue Loss & Concession.

Reducing days of sales outstanding.

Settling all pending payments in minimum time.

Collection of dues in minimum time.

Maintaining and regulating the manpower & outsourced cost within the approved limit.

Ensuring timely payment of doctor's salary.

Ensuring timely payment of outsourced agencies.

Operations Management

Monitoring the operations related to Patient services,OPD,IPD,TP A,Recovery,diagnostic departments, customer care,

medical records, maintenance, security, materials department and Pharmacy. Planning effective control on materials and inventory by implementing proper preventive checks for the unit. Overseeing the maintenance of Hospital building / components including interior utilities and equipment.

Marketing Management

Analyze review market

Response/ requirements and implement strategies for accomplishment of business goals.

Implement schemes/ sales promotions aimed at maximizing brand awareness. Job profile includes:

Organization Profile Multi-Specialty Manav Hospital Job Profile – OPERATION HEAD

(Hospital Administration, Billing, TPA, Recovery, Empanelment, Marketing Team Handle) 1) Increasing revenue of the Hospital by increasing numbers of patients in the hospital and increasing third party paying customers of the hospital.

2) Hospital Operations (Non-Clinical) & Administration - General Management of the hospital including Front Office (OP & IP), Housekeeping, Transport, Security, Maintenance, Statutory Licensing, BMW

,Laundry, Stores, Ambulance, cafeteria.

3) Heading departments of IPD Billing, Credit Patient Dept (TPA & corporate), dispatch & recovery, Marketing team

4) Establish marketing contacts with corporations, insurers, and other third party purchasers of health care services, conducting presentations to these organizations of the services and facilities of the hospital, and organizing direct negotiations and contacts for services with these organizations. 5) To effectively interface with patients/ attendants, employees, vendors and doctors and Provide timely services with accuracy in billing both cash and credit patients. 6) Initiate the recovery of overpaid IPD patient bill a bill and to monitor progress of recovery and payment options.

7) TPA Empanelment & Government Tie-ups

8) TPA or Cashless Recoveries

9) Corporate Company and Government Company cashless Recoveries’ 10) ECHS,CGHS,ESI, cashless Recoveries

11) Handle the Hospital Billing Team, Cashless/TPA Team /Dispatch/recovery Team . 12) Develop corporate tie-ups, company empanelment 13) Liaison with Insurance Companies

14) Liaison with Govt. Health Departments

15) Marketing Offline and Online

16) Referrer Marketing

Organization Profile: Vipul Med Cop Insurance TPA Private Limited Job Profile-Manager-Networking since year 07 Jan 2017 1. Hospital empanelment,

2. check empanelment document

3. Rate issue to hospital

4. Visit to hospital audit check all hospital documents Organization Profile :Privat Hospital, a part of Privat Health Care Group, consist of Privat Hospital, and Privat Travel Clinics.

Privat Hospital, a 100 bedded multi specialty hospital, is on panel of diplomatic missions in India, foreign insurance / assistance company, Multinational and National Corporate. JOB PROFILE- BILLING & TPA Manager

Responsibilities and key tasks

1. To effectively interface with patients/ attendants, employees, vendors and doctors and Provide timely services with accuracy in billing both cash and credit patients. 2. To prepare and update the daily sales register & updating of the sales in the HIS. 3. To oversee correct billing of credit patients as per agreement and timely submission. 4. To oversee dispatch of bills to corporate and panel company. 5. To develop rapport with service user areas and foster teamwork within and across functions. 6. To reconcile Cash/ Credit Card / Demand Draft/ etc. with Invoices. 7. To be well groomed, punctual & adhere to company policies and practices. 8. To have complete Awareness about Disaster Management Program (DMP) of the hospital 9. And to implement billing (hard) in case of shut down of system. 10. To Comply with the service quality Process, environmental & occupational issues & 11. policies of the respective area

12. To comply with patient safety policy as per wrong identification while billing. 13. To reconcile credit billing with receivable and deductable panel company wise 14. Daily/Monthly and report same to COO in the

15. IPD Billing Supervision national & International billing 16. Responsible for handling the billing claims and Resolves the denied claims 17. Prepare and distributed the customer invoice and bill 18. Coordinate with various consultants for all inpatients billing related services and be one point of contact for them for their queries related the patient’s bills and their shares. 19. for Day to day IP Billing activities/process and answering to patient queries and grievances. 20. Heading departments of IPD Billing, Credit Patient Dept (TPA & corporate), Health Check Ups, Customer Care Services & Diagnostics Services (Pathology & Radiology) 21. Responsible for the analyzing researching and resolving customer issue 22. Manages the Reconciliation of accounts receivable on daily basis 23. Keeping Control of the Medical Cases as well as outstanding payment Control 24. Audit claim files, check claim papers according to disease, examine medical reports, match prescriptions and in case of deficiencies of documents, put queries and to make correspondence with clients

25. Review and process claims according to medical terminology, diagnostic procedures and of equipments

26. Passing insurance claim according to health insurance policies for individual and corporate clients and prepare reports

27. Keep the staff well motivated and positive

28. Coordinate with various departments to correct the processes leading to delays Organization Profile: Tulip Hospital, a 100 bedded multi specialty hospital. JOB PROFILE- Collection Recovery & Business Development Assistant Manager 1. Collection to all TPA and All insurance company &all corporate credit collection 2. And ECHS and ESI collection also.

3. Responsible for handling the billing claims and Resolves the denied claims. 4. Prepare and distributed the customer invoice and bill Coordinate with various consultants for all inpatients billing related services and be one point of contact for them for their queries related the patient’s bills and their shares.

5. Care management and insurance / T.P.A. Management. I was handling cashless department 6. Correspondence with TPA and Insurance Company, follow-up with Branch Manager and make a rapid. process of urgent cashless payment. To do correspondence with patient and corporate client for processing.

7. Cashless claim and maintain hospital in proper manner. I was maintain monthly data and to send to Director.

8. Maintaining relations with Insurance Companies and Corporate. 9. Reconciliation with TPA and Corporate for Outstanding amount. Organization Profile: Privat Hospital, a part of Privat Health Care Group, consist of Privat Hospital and Privat Travel Clinics.

JOB PROFILE: TPA/ Billing Sr.Executive at Privat Hospital, Gurgaon 1. IPD Billing Supervision national & International billing 2. Responsible for handling the billing claims and Resolves the denied claim 3. Supervision of all TPA Insurance cases

4. Supervision of Credit Bills realization

5. Controlling various activities in IPD – Advance, Daily Billings 6. Dispatch of credit bills and maintain data for dispatch of credit bills. 7. Collection of credit amount from Debtors.

8. Review of outstanding and reconciliation with debtors. 9. Taking care for deduction claims and recovery of deduction amount. 10. Analyzing of discount report

11. To submit the monthly MIS and Statistics reports. 12. Submission of MIS, Statistic Reports

13. Handling Independent Correspondence with the Companies & Customers 14. Coordinate with the Team to identify process improvement opportunities 15. Supervision of all TPA Insurance cases

16. Implementation of Billings Process & systems

17. Control Cash and Credit Billings

18. Regular client visits and follow ups

Organization Profile: ASIA MEDICAL ASSISTANCE PVT.LTD JOB PROFILE: Accounts Executive

1. Maintaining books of accounts on a day-to-day basis 2. Updating all kinds of payments &receipts in the accounting soft ware 3. Handling of petty cash

4. Vendor reconciliation and collection controller 5. Preparation of bank reconciliation statement

6. Purchase Entry, Sales Entry, Journal Entry, Payment Entry, Receipts Entry, daily updated in the system

7. Cheque preparation of supplier and Expenses

8. Supplier and Expenses bill checking

9. Cash book updating in the system,

(MANISH KUMAR)

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