Intake Exceptions Specialist

globalcareers-ventrahealth; Mabalacat; On-site; PHP 2,375,000 - 3,375,000; Full time

Job summary

Ventra Health seeks an Intake Exceptions Specialist to enter and maintain insurance and patient demographics at the encounter level, with system-level duties for experienced incumbents. You will research, validate, and update crosswalks and insurance data while ensuring accuracy and compliance in a fast-paced setting.

The role emphasizes reviewing volumes, cross walking opportunities, and delivering high-quality service. A base requirement is a high school diploma with some billing experience.

Qualifications

• High School Diploma or GED.
• At least six (6) months of experience with insurance/professional medical billing preferred.

Responsibilities

• Reviews demographics pulled from hospital system and assigns insurance plans to each patient chart.
• Enters all patient information accurately prior to chart being coded.
• Corrects errors based on insurance billing requirements.
• Adds and maintains insurance information within system through proper research.
• Identifies ‘Red Flag’ issues and provides proper research to deliver a solution.
• Performs internet research to determine insurance presented is legitimate.

Skills

Insurance data entry

Demographics accuracy

Research skills

Communication skills

Time management

Team collaboration

Education

High School Diploma or GED

Tools

Outlook

Smartsheet

Excel

Database software

Job description

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

Job Summary

• The Intake Exceptions Specialist is primarily responsible for entering and maintaining insurance and patient demographic information accurately, through research and follow up, at the individual encounter level. At the Intake Coordinator II level, this is amplified to include maintaining insurance at the system level and performing cross walking functions.

Essential Functions and Tasks

• Reviews demographics pulled from hospital system and assigns insurance plans to each patient chart
• Enters all patient information accurately prior to chart being coded
• Corrects any errors based on insurance billing requirements
• Adds and maintains insurance information within system through proper research
• Identifies any ‘Red Flag’ issues and provides proper research to deliver a solution
• Provides support for any major projects within department
• Performs internet research to determine insurance presented is legitimate
• Review volumes of spreadsheet data, sent to Ventra by facilities, to determine insurance crosswalks that need to be made
• Compares insurance information, provided by the facilities, to Ventra insurance data to perform matches on insurance name, line of business type (financial class), and local area special arrangements for cross walking opportunities
• Enters valid crosswalks into Ventra systems
• Performs special projects and other duties as assigned

Education and Experience Requirements

• High School Diploma or GED
• At least six (6) months of experience with insurance/professional medical billing preferred

Knowledge, Skills, and Abilities

• Working knowledge of the front-end process for each facility
• Working knowledge of medical terminology, anatomy and physiology, legal aspects of health information
• Knowledge of Electronic Medical Records (EMRs) such as Cerner, Meditech, Epic, PICIS
• Ability to read, understand, and apply state/federal laws, regulations, and policies
• Ability to communicate with diverse personalities in a tactful, mature, and professional manner
• Ability to remain flexible and work within a collaborative and fast paced environment
• Ability to deliver high quality service excellence with high attention to detail
• Understand and comply with company policies and procedures
• Strong oral, written, and interpersonal communication skills
• Strong time management, organizational, and decision-making skills
• Strong knowledge of Outlook, Smartsheet, Excel, and database software skills

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.

• This position is also eligible for a discretionary incentive bonus in accordance with company policies.

Ventra Health

Equal Employment Opportunity (Applicable only in the US)Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.Recruitment AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention CandidatesPlease be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services.These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at [e-mail] to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.

Statement of AccessibilityVentra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.