Verification of Benefits Specialist

Role Description

Our client is a US-based behavioral health and substance use treatment provider delivering care across the full continuum — Detox, Residential, Partial Hospitalization (PHP), Intensive Outpatient (IOP), and Outpatient (OP). Treatment cannot start without financial clearance, and financial clearance starts with you. As the Verification of Benefits (VOB) Specialist, you sit at the intersection of admissions, billing, and clinical operations, owning the verification workflow that determines whether a client is covered, what level of care their plan supports, and what authorizations are required before care begins.

This is a 100% remote, full-time role for a detail-driven insurance professional who can move quickly without sacrificing accuracy. You will run VOBs end-to-end, document them in the client's EMR face sheet, and translate complex commercial and government benefit structures into clear, actionable summaries for the teams who rely on them. Twice a month — on the 1st and the 16th — you will re-verify every active client policy to catch lapses, terminations, or coverage changes before they disrupt treatment. You will also track COBRA and Marketplace premium payments, where a missed payment can quietly end coverage mid-treatment.

Within 90 days you will be the team's trusted source of truth for insurance status. Within 6 months you will have visibility into face-sheet auditing, basic billing entry, and eligibility-driven claim follow-ups during low-volume periods — building you into a more versatile revenue cycle contributor over time.

Responsibilities

• Perform timely and accurate verification of benefits (VOBs) for all incoming clients across Detox, Residential, PHP, IOP, and OP levels of care.
• Confirm coverage, benefit limitations, co-pays, deductibles, out-of-pocket maximums, exclusions, and pre-authorization requirements with each payer.
• Input VOB findings into designated tracking systems and update the client's EMR face sheet with complete supporting documentation.
• Communicate verified benefits clearly and promptly to admissions, billing, and clinical teams to enable smooth intake and continuous care coordination.
• Conduct bi-weekly re-verification of all active client insurance policies on the 1st and the 16th of every month, identifying and addressing changes, lapses, or terminations.
• Monitor and track COBRA and Marketplace premium payments for active clients on those coverage types, communicating any lapses or pending payments that may affect continued coverage.
• Maintain clear documentation of premium statuses and any outreach or action taken with clients or internal teams.
• Audit client EMR face sheets for accurate and complete insurance information during lower-volume periods.
• Enter client admission and discharge data into the billing system when the Hybrid Billing Coordinator is unavailable or at capacity.
• Assist with initial claim follow-ups for basic eligibility denials or coverage mismatches as needed.
• Upload VOB documentation to the client's EMR face sheet in collaboration with the Hybrid Billing/VOB Specialist.
• Complete special assignments and other duties as requested by the supervisor.
• Maintain HIPAA compliance and protect patient confidentiality at every step of the workflow.

Qualifications

• Prior hands-on experience with insurance verification of benefits in a US healthcare setting.
• Strong working knowledge of US commercial insurance (BCBS, Aetna, Cigna, UHC, Humana) and government payers (Medicare, Medicaid, Tricare) including pre-authorization processes.
• Direct experience using an EMR system to update face sheets and document insurance information.
• Familiarity with COBRA continuation coverage and Affordable Care Act Marketplace plans, and how premium payment status affects active coverage.
• Excellent attention to detail with the ability to spot missing or contradictory benefit information.
• Effective verbal and written English communication, including comfort on phone calls with US payers and async written handoffs to internal teams.
• Ability to work independently, prioritize a daily queue, and meet turnaround expectations in a fast-paced environment.
• Demonstrated HIPAA awareness and respect for patient confidentiality.
• Reliable home internet, a quiet remote work environment, and willingness to overlap with US Mountain Time business hours.

Nice to Have

• VOB experience specifically in behavioral health, mental health, or substance use treatment settings.
• Working knowledge of behavioral health benefit structures (parity, level-of-care criteria, concurrent review) and pre-authorization for SUD/MH services.
• Experience with healthcare billing systems and initial claim follow-up on eligibility-based denials.

Benefits

• 100% remote, full-time role with a US-based behavioral health team.
• USD $6/hour compensation.
• Defined ownership of the VOB workflow and a clear path into broader revenue cycle responsibilities.
• A team that values accuracy, async clarity, and people who close the loop without being chased.

Data Privacy

By applying, you consent to being contacted via the contact information provided in your application for recruitment purposes only.

Interview Scheduling

Initial calls run in US Mountain Standard Time (MST), scheduled within a 3:00 AM – 1:00 PM MST window. We genuinely appreciate applicants' flexibility around the time difference.