Medical Registration Specialist (Spine Surgery)

The ideal candidate has strong experience with U.S. health insurance verification and medical registration, understands insurance terminology and coverage requirements, and is comfortable communicating directly with insurance companies. You should be proactive, highly organized, and meticulous when handling patient and insurance information.

Key Responsibilities

• Accurately register patients and enter demographic and insurance information into the appropriate system
• Review patient registration information for completeness and accuracy
• Enter and maintain relevant documentation within the EMR/EHR
• Upload documents and supporting records into patient charts
• Process and organize provider referrals
• Assist with insurance authorization-related documentation as required
• Reference clinical notes and reports through the EHR/EMR when necessary
• Ensure patient charts contain the appropriate registration and insurance documentation
• Maintain accurate, organized, and confidential electronic patient records
• Handle patient-related inquiries and correspondence as required within the scope of the role

Insurance Verification & Benefits

• Verify patient insurance eligibility and benefits directly with insurance companies
• Navigate insurance portals to obtain and confirm coverage information
• Make outbound calls to insurance providers when portal information is unavailable or additional clarification is required
• Verify coverage details, including:
• Eligibility and active coverage
• Benefits
• Deductibles
• Copays
• Coinsurance
• Authorization requirements
• Document insurance verification results accurately in the appropriate system
• Identify missing, conflicting, or incomplete insurance information and take appropriate steps to resolve discrepancies
• Communicate with insurance representatives regarding coverage and authorization requirements
• Maintain accurate records of insurance calls, portal findings, reference numbers, and follow-up requirements

Referrals & Authorization Support

• Review and process incoming provider referrals
• Confirm that required referral and insurance information is complete
• Assist with insurance authorization requirements related to patient registration
• Coordinate documentation needed for insurance processing
• Track outstanding insurance or referral requirements
• Follow up with insurance companies as needed to obtain necessary information
• Help ensure registration and insurance requirements are completed accurately and promptly

Key Areas of Focus

1. Patient Registration & Documentation
Ensure demographics, insurance details, referrals, and supporting documentation are entered accurately and properly maintained within patient records.

2. Insurance Verification & Portal Navigation
Verify eligibility, benefits, patient financial responsibility, and authorization requirements using insurance portals and direct payer communication.

3. Insurance & Referral Coordination
Work with insurance companies and internal records to resolve missing information, process referrals, and support authorization requirements efficiently.

Requirements

Required Skills & Experience

• Previous experience with medical registration, insurance verification, eligibility and benefits verification, or a similar U.S. healthcare administrative function
• Hands-on experience verifying insurance eligibility and benefits directly with U.S. insurance companies
• Experience navigating insurance portals and retrieving patient coverage information
• Experience making outbound calls to insurance companies
• Strong understanding of U.S. health insurance terminology and processes
• Knowledge of benefits, deductibles, copays, coinsurance, eligibility, and authorization requirements
• Understanding of Workers’ Compensation and Medical Provider Networks (MPN)
• Familiarity with provider referrals and insurance authorization workflows
• Experience accurately entering patient demographics and insurance information
• Experience uploading and maintaining documents within patient charts
• Familiarity with EHR/EMR systems such as Athena, Epic, Cerner, or similar platforms
• Ability to review and reference clinical notes and reports when required
• Working knowledge of medical terminology
• Strong attention to detail and commitment to accuracy
• Strong organizational and documentation skills
• Excellent professional phone and written communication skills
• Ability to independently identify and resolve missing or conflicting information
• Ability to manage confidential patient and insurance information appropriately
• Strong understanding of and adherence to HIPAA requirements

Preferred Experience

• Previous experience supporting a U.S.-based spine, orthopedic, surgical, or specialty medical practice
• Experience with spine surgery-related registration or insurance workflows
• Experience working with Workers’ Compensation cases
• Experience with MPN requirements
• Experience using Athena
• Experience using Epic
• Experience using Cerner
• Experience coordinating provider referrals and insurance authorizations

Basic Requirements

• Must speak and write English clearly and professionally.
• Must have relevant work experience.
• Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory).
• Must be available to attend video meetings with camera on when required.

Technical Requirements

• Computer: Reliable laptop or desktop computer.
• Internet: Stable high-speed internet connection (minimum 25 Mbps).
• Audio: Noise-canceling headset.
• Video: Working webcam for virtual meetings.
• Workspace: Quiet and professional work environment.