Intake Exceptions Specialist

Ventra Health; Philippines; On-site; PHP 279,000 - 424,000; Full time

Job summary

Ventra Health in the Philippines seeks an Intake Exceptions Specialist to accurately enter and maintain insurance and patient demographic information at the encounter level, with system-wide responsibilities at level II.

You will review demographics, assign insurance plans, verify data before coding, conduct research, and support major department projects. The role emphasizes accuracy, attention to detail, and collaboration in a fast-paced environment; prior billing experience is preferred.

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 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.

Skills

EMR knowledge

Medical terminology

Communication skills

Time management

Attention to detail

Education

High School Diploma or GED

Tools

Cerner EMR

Meditech

Epic

PICIS

Outlook

Smartsheet

Excel

Job description

• Enters valid crosswalks into Ventra systems

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.

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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 incentiv e bon us 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 Agencies

Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.

Solicitation of Payment

Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.

Statement of Accessibility

Ventra 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/.