Patient Eligibility Registration Specialist

We are looking for a detail-oriented Patient Eligibility Registration Specialist to support the patient registration process by verifying insurance coverage, ensuring authorizations are in place, and maintaining accurate documentation to facilitate timely patient care.

• Patient Eligibility Registration Specialist

• Work from home

• Monday to Friday | 8:00 PM to 5:00 AM (Manila) 

• *Following US Holidays
  

• →Gain and maintain a thorough understanding of patient insurance eligibility and benefits across a wide range of payers, including but not limited to: Aetna, Cigna, BCBS, Humana, Workers’ Comp, Medicare, and Medicaid.

• →Verify patient insurance coverage and benefits by contacting insurance companies and reviewing online payer portals.

• →Confirm deductibles, copays, and coinsurance amounts, and out‑of‑pocket maximums.

• →Generate and communicate “Estimate of Patient Financial Responsibility” forms to patients in a clear and timely manner.

• →Secure necessary approvals from insurance carriers before specific procedures or treatments are performed.

• →Identify and resolve discrepancies, coverage issues, and insurance-related errors by coordinating with insurance providers and internal teams.

• →Maintain well‑organized, accurate records of all verification activities, communications, and documentation.

• →Prepare and update individual patient files and related documentation while ensuring compliance with HIPAA regulations, payer policies, and company standards.

• →Continuously build a broad knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.

• →Collaborate with internal teams to resolve discrepancies and ensure data accuracy.

• →Perform other duties and special projects as assigned.
  

• A minimum of 2-3 years of healthcare industry experience in intake/verification roles.

• Previous experience in Orthopedic, Spine Surgery, and Pain Management Specialty a plus.

• Understanding of different types of insurance coverages and claims, including Health, Workers' Comp, and Auto.

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

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

• Effective written and verbal communication skills.

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