Patient Eligibility Registration Specialist

Summary:

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.

Job Details:

• Patient Eligibility Registration Specialist

• Work from home

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

• *Following US Holidays
  

Responsibilities:

• 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.
  

Qualifications:

• 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.