ASSISTANT, BILLING

GENERAL DESCRIPTION

• The Billing & Discharge Clerk is responsible for managing the inpatient billing and discharge processes to ensure accurate, timely, and efficient financial clearance for patients. The role ensures that all hospital charges are accurately captured, bills are finalized in accordance with hospital policies and Standard Operating Procedures (SOPs), and all financial and insurance requirements are fulfilled prior to patient discharge.
• The Billing & Discharge Clerk works closely with consultants, nursing units, pharmacy, laboratory, radiology, finance, medical records, insurance companies, Third Party Administrators (TPAs), corporate clients, and other relevant departments to facilitate smooth discharge operations while providing excellent customer service. The role is also responsible for coordinating Guarantee Letters (GL), Final Guarantee Letters (FGL), Letters of Undertaking (LOU), billing adjustments, Credit Notes (CN), Debit Notes (DN), insurance claims, and financial documentation to ensure compliance with hospital policies, regulatory requirements, and accreditation standards.
• In addition, the Billing & Discharge Clerk maintains accurate billing and discharge records, supports audit and financial reporting requirements, safeguards patient confidentiality in accordance with the Personal Data Protection Act (PDPA), resolves billing-related enquiries, and contributes to continuous process improvement initiatives to reduce discharge turnaround time, improve billing accuracy, and enhance patient satisfaction. The incumbent is expected to perform all duties with professionalism, integrity, accountability, and a commitment to delivering quality healthcare services.

JOB SUMMARY

• The Billing & Discharge Clerk is responsible for ensuring the accurate and timely processing of inpatient billing, financial clearance, and patient discharge activities in accordance with hospital policies, Standard Operating Procedures (SOPs), and regulatory requirements. The role is responsible for verifying and processing hospital charges, preparing and finalizing patient bills, coordinating insurance and Guarantee Letter (GL) requirements, collecting payments, and ensuring all billing documentation is complete before patient discharge.
• The Billing & Discharge Clerk works closely with consultants, nursing units, pharmacy, laboratory, radiology, finance, medical records, insurance companies, Third Party Administrators (TPAs), corporate clients, and other relevant departments to facilitate a smooth and efficient discharge process. The incumbent is also responsible for maintaining accurate billing records, resolving billing-related enquiries, ensuring compliance with financial and healthcare regulations, and supporting continuous process improvement initiatives to enhance billing accuracy, reduce discharge turnaround time, and improve patient satisfaction.

JOB DESCRIPTION

ORGANIZATION AND MANAGEMENT

Understands and carries out the Business Operation in line with Vision and Mission Statements, Philosophy, Goals and Objectives that suit the scope of the Services and hospital.  Understands the service organization structure.  Informs (Immediate Superior] when changes occur in circumstances which affect standard of services.  Attends meetings held by the services in order to discuss issues and matters pertaining to the operation of the service.  Report to the workstation at least 10 minutes before the start of the shift, maintaining a high standard of personal grooming in accordance with the Front Office Grooming Guidelines. Participate in shift rotations as scheduled in the Business Office Duty Roster to ensure smooth and continuous operational coverage Answers phone calls and relay messages. Submits report on requested. To perform any other relevant duties as and when required by the management.

Daily routine:  

10.1. Billing Management

a. Prepare, review, and process inpatient bills accurately and in a timely manner.

b. Receive charge forms from wards and departments and ensure all inpatient charges are entered into the Hospital Information System (HITS) on a daily basis.

c. Verify patient information, treatment details, billing documentation, and supporting medical records to ensure billing accuracy.

d. Ensure all medical, pharmacy, laboratory, radiology, theatre, consumables, and ancillary service charges are completely and accurately posted before bill finalization.

e. Prepare and process Debit Notes (DN) and Credit Notes (CN) arising from amendments, billing adjustments, or differences in the Final Guarantee Letter (FGL) issued by insurance companies or corporate payers.

f. Maintain accurate billing records and ensure all supporting documents are properly filed for audit and reconciliation purposes.

g. Ensure compliance with hospital billing policies, finance procedures, insurance requirements, and applicable healthcare regulations.

10.2. Patient Discharge Management

a. Coordinate the overall discharge process with doctors, nursing units, pharmacy, laboratory, radiology, housekeeping, finance, and other relevant departments to facilitate timely patient discharge.

b. Ensure all discharge documentation, charges, and approvals are complete before releasing the patient.

c. Verify that all charges have been entered by the respective departments to prevent omitted or late charges.

d. Ensure financial clearance is obtained before patient discharge.

e. Facilitate smooth communication with patients, family members, consultants, and internal departments regarding discharge arrangements.

f. Handle special discharge arrangements, including VIP patients, health tourism cases, corporate patients, and emergency discharges.

10.3. Insurance & Guarantee Letter (GL) Management

a. Review and verify insurance coverage, Guarantee Letters (GL), Letters of Undertaking (LOU), and corporate authorization prior to patient discharge.

b. Prepare complete billing documentation and submit final bills to insurance companies, TPAs, or corporate clients to obtain the Final Guarantee Letter (FGL).

c. Follow up with insurance companies, TPAs, and corporate clients on pending FGL approvals and rejected claims.

d. Resolve billing discrepancies, claim queries, and documentation issues in collaboration with the relevant departments.

e. Process patient discharges under the Patient Discharge Without Final Guarantee Letter (PDWFGL) procedure in accordance with hospital policy and approved guidelines.

10.4. Financial Clearance & Collections

a. Review finalized bills and collect deposits, co-payments, excess payments, and outstanding balances before patient discharge.

b. Ensure bills are allocated against payments in the system on the same day of patient discharge.

c. Follow up on outstanding balances, refunds, excess payments, and pending collections through telephone calls, written correspondence, or other approved communication channels.

d. Coordinate with the Credit Administration Team to ensure complete billing documentation is submitted within three (3) working days after receipt of the Final Guarantee Letter.

10.5. Customer Service

a. Provide professional explanations to patients and guarantors regarding hospital charges, estimated costs, payment methods, deposits, and billing enquiries.

b. Explain the Letter of Undertaking (LOU), financial responsibilities, and payment obligations before admission or discharge.

c. Respond promptly and professionally to patient enquiries, complaints, and billing disputes, escalating complex issues to the immediate superior where necessary.

d. Ensure patients receive all relevant discharge documents, including receipts, billing statements, refund information, and financial clearance documentation.

10.6. Documentation & Compliance

a. Maintain complete, accurate, and up-to-date billing and discharge records.

b. Ensure all billing, financial, insurance, and discharge documents are securely filed and easily retrievable.

c. Safeguard patient confidentiality in compliance with the Personal Data Protection Act (PDPA) and hospital confidentiality policies.

d. Comply with all hospital Standard Operating Procedures (SOPs), finance policies, insurance requirements, and healthcare regulations.

e. Support internal and external audits by preparing required reports and documentation.

f. Participate in month-end closing activities, reconciliation, and financial reporting.

10.7. Operational Improvement

a. Monitor discharge turnaround time and identify opportunities to improve workflow efficiency.

b. Participate in departmental quality improvement initiatives, Lean projects, and process enhancement activities.

c. Recommend improvements to reduce discharge delays, billing errors, omitted charges, and claim rejections.

d. Assist in developing and reviewing departmental SOPs, work instructions, and process documentation.

10.8. Teamwork & Collaboration

a. Work collaboratively with Admission, Credit Administration, Finance, Nursing, Pharmacy, Medical Records, Consultants, Laboratory, Radiology, and other departments.

b. Ensure proper handover of pending cases during shift changes to maintain continuity of operations.

c. Provide guidance and on-the-job training to new staff and support cross-functional duties when required.

d. Perform any other duties assigned by the Head of Department, immediate superior, or Hospital Management.

Decision-Making Authority

The Billing & Discharge Executive/Officer is authorized to:

• Finalize patient discharge upon confirmation of financial clearance and completion of billing requirements.
• Process routine billing adjustments, refunds, debit notes, and credit notes within the approved authority limits.
• Coordinate directly with insurance companies, TPAs, corporate clients, consultants, and internal departments regarding billing and discharge matters.
• Escalate complex billing disputes, high-value cases, exceptional financial arrangements, or policy exceptions to the immediate superior or Hospital Management for approval.

  11. Additional Responsibilities

• Participation in New Services: Actively support the implementation of new hospital services and system improvements.
• General Duties: Perform any other related duties as assigned by superiors to support departmental objectives.
• Policy & Procedure Compliance: Adhere to all hospital financial and operational policies, maintaining accurate records at all times.
• Corrective Actions: Take prompt action to address and resolve compliance or audit-related issues.
• Audit Performance: Ensure full compliance with internal and external audit requirements.
• Data Protection: Maintain strict confidentiality of all patient information and ensure full PDPA compliance.

    12. Operational Performance Standards

Charge Verification: Review and verify all patient charges (consultations, procedures, medications, room, etc.) before submitting the final bill to prevent overcharging or omissions. Discharge Bill Submission: Submit discharge bills promptly to the Credit Administration Department upon receipt of the Final Guarantee Letter (FGL). Insurance Query Handling: Respond promptly to insurer or TPA queries within the specified turnaround time to avoid claim delays. Credit/Debit Note Management: Issue Credit Notes (CN) or Debit Notes (DN) immediately upon receipt of the final GL when adjustments are required. Cash-Paying Patients: Process bills for self-paying patients efficiently ensuring that 95% of discharges are completed within 45 minutes. GL Approval for Discharge: Strive to obtain GL discharge approval within 2 hours of request to minimize patient waiting time. PDWFGL Implementation: Apply the Patient Discharge without Final Guarantee Letter policy responsibly, ensuring all approvals and documentation are properly in place. Refunds: Expedite refunds for any excess deposits, ensuring timely and

     13. Compliance to general terms:-

Personal appearance

Is appropriate for the work environment and meets expectation for the proper image of the hospital, as per services policies.

Attendance

Following hospital’s policy regarding punctuality and attendance.

ADDITIONAL DUTIES AND RESPONSIBILITIES IN THE SPECIFIC AREAS (If any)

Giving high quality of service to the patients.  Ensuring all patients safety at all conditions

Disclaimer

This job description serves as a general guideline to the key responsibilities and expectations of the position. It may be amended or updated as necessary in response to organizational needs or operational changes. This document does not form part of the employment contract.

JOB REQUIREMENT :

Education:

• Minimum SPM/STPM.

Knowledge and Experiences:

• Preferable 1-2 years working experience.
• Able to communicate in English and Bahasa Malaysia
• Giving high quality of service to the patients.
• Ensuring all patients safety at all conditions

Special skills required

• Have interpersonal and communication skills.
• Dynamic, honest and responsible worker.
• Willingness to work on scheduled hours, shift, and weekends, public holidays and anytime when called during emergency.

Personal attributes

• Has good communication, counseling and interpersonal skills. Able to guide new staff and other related staff.
• Possess the attitude to make the patient care the primary concern, treating every patient compassionately, demonstrating and an aspiration to altruism.
• Seek to serve, maintain patient’s dignity, privacy, autonomy and confidentiality. Prepared to work as a team member.