Registration/Eligibility Edits Specialist

Ventra Health; Morong; On-site; PHP 360,000 - 480,000; Full time

Benefits offered by this job

Performance-based incentive

Job summary

Ventra Health is seeking a Registration/Eligibility Edits Specialist to ensure accurate patient demographics for accurate medical billing and claims processing. You will verify insurance information, reduce errors, and help secure timely reimbursement by updating records and correcting data discrepancies.

You will work in a fast-paced environment, handling HIPAA compliance, and collaborating with teams to maintain data integrity across billing systems.

Qualifications

• High School Diploma or equivalent is required.
• 1–2 years in medical billing, patient registration, insurance verification, or related role.
• Knowledge of insurance plans, billing processes, and HIPAA compliance.
• Familiarity with EHR and billing systems (Epic, Cerner, Athena).

Responsibilities

• Validate patient demographics for billing accuracy.
• Verify insurance eligibility through payer portals and update records.
• Maintain HIPAA compliance and document corrections for audits.

Skills

HIPAA compliance

Communication skills

Time management

Microsoft Excel

Outlook

Teamwork

Education

High School Diploma or equivalent

Tools

Epic

Cerner

Athena

Job description

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.

Come Join Our Team!

• 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 Registration/Eligibility Edits Specialist is responsible for ensuring the accuracy and completeness of patient demographics information used for medical billing and claims processing.
• This role is critical in reducing the billing errors and ensuring the timely reimbursement by verifying the insurance information, correcting data discrepancies, and maintaining up-to-date patient records.

Essential Functions And Tasks

• Validate Patient Demographics: Review and ensure accuracy of patient details such as name, date of birth, address, and contact info in billing systems.
• Verify Insurance Information: Confirm insurance coverage and eligibility through payer portals or clearinghouses, and update records accordingly.
• Maintain Compliance and Documentation: Adhere to HIPAA regulations, maintain data confidentiality, and document all corrections and validations for audit purposes.

Education And Experience Requirements

• High School Diploma or equivalent (required).
• 1–2 years of experience in medical billing, patient registration, insurance verification, or related healthcare administrative role.
• Knowledge of insurance plans, billing processes, and HIPAA compliance.
• Familiarity with Electronic Health Records (EHR) and billing systems (e.g., Epic, Cerner, Athena).

Knowledge, Skills, And Abilities

• 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.
• Basic use of computer, telephone, internet, copier, fax, and scanner.
• Basic touch 10 key skills.
• Basic Math skills.
• Understand and comply with company policies and procedures.
• Strong oral, written, and interpersonal communication skills.
• Strong time management and organizational skills.
• Strong knowledge of Outlook, Word, Excel (pivot tables), 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.

Attention Candidates

Please 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 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/.