Registration/Eligibility Edits Specialist

Ventra Health, Inc.; Philippines; On-site; PHP 180,000 - 240,000; Full time

Job summary

Ventra Health in the Philippines is seeking a Registration/Eligibility Edits Specialist to handle front-end claims, verify edits, and ensure timely release to payors. You will support team members, request missing information from clients, and help resolve overlaps with accuracy and compliance.

The role requires attention to detail, strong communication, and flexibility to work in a fast-paced environment across the country.

Qualifications

• High School Diploma or GED.
• At least 1–2 years in data entry and medical billing preferred.
• Strong Excel, Outlook, Word skills and basic database familiarity.

Responsibilities

• Monitor intake processes and verify that TES, CAR, and Claim Edits are worked daily.
• Assist colleagues with escalation resolution.
• Provide feedback and training to other colleagues on front end processes.
• Request and log missing information from clients.
• Assist with resolution of overlaps that colleagues cannot address.
• Performs special projects and other duties as assigned.

Skills

Data entry

Medical billing

Communication

Excel pivot tables

Outlook/Word

Team collaboration

Attention to detail

Basic math

Education

High School Diploma or GED

Job description

Registration/Eligibility Edits Specialist

Company: Ventra Health. Job Type: Full Time. Location: Philippines.

Job Description - Registration/Eligibility Edits Specialist

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.

Job Summary

• The Pre-Bill Specialist is responsible for the first steps in the billing process. The Pre-Bill Specialists are assigned a set of edits, and they are responsible for ensuring that all claims are released to the payors and move through the front-end workflow within Ventra’s set standards. The Pre-Bill Specialist must comply with applicable laws regarding billing standards and be able to operate in a team-oriented environment that strives to provide superior service to our providers throughout the country.

Essential Functions and Tasks

• Monitor intake processes and verify that all TES, CAR, and Claim Edits are worked daily.
• Assist colleagues with escalation resolution.
• Provide feedback and training to other colleagues surrounding front end processes.
• Request and log missing information from clients.
• Assist with resolution of possible overlaps that other colleagues are not able to address.
• Performs special projects and other duties as assigned.

Education and Experience Requirements

• High School Diploma or GED.
• At least one (2) year in data entry and medical billing preferred.

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 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 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/.