Patient Eligibility Registration Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Develop and uphold a comprehensive understanding of patient insurance eligibility and benefits from various payers, such as Aetna, Cigna, BCBS, Humana, Workers’ Comp, Medicare, and Medicaid.

• Verify patients' insurance coverage and benefits by reaching out to insurance companies and utilizing online payer portals.

• Confirm details regarding deductibles, copays, coinsurance amounts, and out-of-pocket maximums.

• Create and convey “Estimate of Patient Financial Responsibility” documents to patients.

• Obtain necessary approvals from insurance carriers prior to specific procedures or treatments.

• Identify and rectify discrepancies, coverage issues, and insurance-related errors through collaboration with insurance providers and internal teams.

• Keep precise records of verification activities, communications, and documentation.

• Compile and update patient files and associated documentation in accordance with HIPAA regulations, payer policies, and company standards.

• Enhance knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.

• Partner with internal teams to address discrepancies and ensure data accuracy.

• Execute additional duties and special projects as assigned.

⛳️ Requirements

• At least 2-3 years of experience in the healthcare sector in intake/verification roles.

• Prior experience in Orthopedic, Spine Surgery, and Pain Management Specialty is advantageous.

• Knowledge of various types of insurance coverages and claims, including Health, Workers' Comp, and Auto.

• Familiarity with Revenue Cycle Management (RCM) systems, Practice Management Systems (PMS), and related tools.

• Strong analytical, critical thinking, and problem-solving abilities.

• Excellent written and verbal communication skills.

• Capacity to work independently while effectively collaborating with cross-functional teams.

🏝️ Benefits

• Work from home.

• Monday to Friday schedule.

• Observance of US Holidays.