PM JAY Executive

Sunshine Global Hospital is seeking a detail-oriented and knowledgeable PM-JAY Executive to manage Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) operations and ensure smooth patient enrollment, authorization, billing, and claim processing. The involves coordinating with patients, hospital departments, and government portals to ensure seamless scheme execution and compliance.

Roles & Responsibilities

• Handle end-to-end PM-JAY patient registration, eligibility verification, and enrollment processes.
• Verify patient documents and ensure compliance with PM-JAY scheme guidelines.
• Coordinate pre-authorization requests and approvals through the official PM-JAY portal.
• Liaise with doctors, billing team, and insurance/TPA departments for treatment approvals.
• Ensure accurate entry of patient data and treatment details in PM-JAY system.
• Monitor patient admission, treatment, and discharge under scheme guidelines.
• Prepare and submit claims on the PM-JAY portal within defined timelines.
• Follow up on claim status, approvals, and reimbursements.
• Resolve discrepancies and queries related to claim rejection or pending approvals.
• Maintain proper documentation for audits, inspections, and compliance checks.
• Coordinate with government authorities and scheme representatives as required.
• Educate patients and attendants about PM-JAY benefits, coverage, and procedures.
• Ensure adherence to all scheme policies, SOPs, and regulatory requirements.
• Assist in audit preparation and respond to queries from external auditors.
• Maintain daily reports of PM-JAY cases, approvals, and claim status.
• Support hospital departments in smooth execution of cashless treatment processes.
• Track and manage package rates, eligibility limits, and treatment authorizations.
• Ensure timely submission of discharge summaries and supporting documents.
• Work closely with billing and medical records departments for accurate claim processing.
• Stay updated with PM-JAY guidelines, policy changes, and system updates.

Sunshine Global Hospital is a multi-speciality healthcare institution committed to delivering advanced medical care with a patient-first approach. The hospital focuses on combining clinical expertise, modern technology, and compassionate care to ensure the best outcomes for patients.

Our Story

Sunshine Global Hospital was established with the vision of providing world-class healthcare services under one roof. Over the years, it has developed into a trusted healthcare provider, known for its quality treatment, skilled medical professionals, and commitment to excellence.

Our Mission

• To provide high-quality and affordable healthcare services
• To ensure patient safety and clinical excellence
• To deliver compassionate and ethical care
• To continuously adopt advanced medical technologies

Our Vision

To be a leading multi-speciality hospital recognized for excellence in healthcare services, innovation, and patient satisfaction.

Our Services / What We Offer

Sunshine Global Hospital offers a comprehensive range of medical services:

• Multi-speciality consultations and treatments
• Advanced diagnostic and imaging services
• Surgical and critical care services
• Emergency and trauma care
• Preventive healthcare and wellness programs

Why Choose Us

• Experienced team of doctors and healthcare professionals
• Advanced infrastructure and modern medical technology
• Patient-centric approach with focus on comfort and safety
• Comprehensive healthcare services under one roof
• Commitment to quality and continuous improvement

Our Team

The hospital is supported by a team of skilled doctors, surgeons, nurses, and healthcare staff dedicated to delivering high-quality and compassionate care.

Infrastructure / Technology

Sunshine Global Hospital is equipped with state-of-the-art medical infrastructure, advanced diagnostic equipment, and modern treatment facilities to ensure accurate diagnosis and effective patient care.

Our Commitment

Sunshine Global Hospital is committed to improving healthcare outcomes by delivering safe, reliable, and high-quality medical services. The hospital emphasizes innovation, ethical practices, and patient satisfaction.