Supervisor, Registration/Eligibility Edits

Job Description

About Us

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

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Job Summary

Supervises the registration and eligibility edit resolution team, ensuring accuracy and compliance in pre-claim validation workflows.

Essential Functions and Tasks

Oversee daily processing of registration and eligibility edits to ensure errorfree claim submission

Collaborate with IT and Operations to address recurring system or validation issues

Ensure timely resolution of edit queues and adherence to client and payer standards.

Provide feedback to frontend teams to reduce recurring edit issues.

Track performance metrics and prepare edit error analysis reports for leadership.

Coach team members on effective issue resolution and compliance.

Education and Experience Requirements

High School Diploma or GED.

At least two to four (2-4) years of medical billing and claims resolution experience preferred

AAHAM and/or HFMA certification preferred

Experience with offshore engagement and collaboration desired

Knowledge, Skills, and Abilities

Experience in eligibility and registration edit management within RCM systems.

Strong analytical, problem-solving, and leadership skills.

Knowledge of payer rules and EDI validation requirements.

Become proficient in the use of billing software within 4 weeks and maintain proficiency

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 a 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.

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 Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.

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