Verification of Benefits Specialist

Verification Of Benefits Specialist

We are seeking an experienced Verification Of Benefits Specialist to support healthcare authorization and insurance verification operations in a fast paced healthcare environment. The ideal candidate will work closely with patients, providers, and insurance carriers to ensure timely authorizations, eligibility verification, and reimbursement coordination. This role requires strong communication, organizational, and multitasking abilities while handling multiple cases simultaneously. Candidates with experience in physician offices, medical billing, healthcare support, or utilization review environments are highly preferred. Strong system navigation and attention to detail are essential for success in this role.

Key Responsibilities:

• Verify patient insurance benefits and eligibility information through payer portals and insurance carriers.
• Submit and follow up on authorization, precertification, and utilization review requests.
• Coordinate with insurance carriers, provider offices, and internal teams to resolve authorization and reimbursement issues.
• Review clinical documentation and patient records for completeness and accuracy.
• Process appeals for denied authorization requests and maintain proper documentation.
• Educate patients and providers regarding authorization requirements and insurance processes.
• Maintain accurate records of case status, approvals, denials, and follow up activities.
• Support operational goals by managing multiple cases within required timelines.

Required Qualifications:

• High School Diploma required and Associate Degree preferred.
• Minimum 2 years of experience in verification of benefits, utilization review, medical approvals, or healthcare authorization support.
• Experience working with insurance carriers and healthcare payer portals.
• Knowledge of Medicare, Medicaid, Workers Compensation, and private insurance guidelines.
• Familiarity with codes and ICD10 diagnosis coding.
• Strong communication, organizational, and customer service skills.
• Proficiency with Office, Adobe, Salesforce, and computer navigation.

Preferred Qualifications:

• Experience working in physician offices or healthcare provider environments.
• Experience with medical device or DME billing.
• Medical billing software experience.
• Experience training providers or patients on authorization processes.
• Ability to work effectively in a fast paced team environment.

Benefits:

The Company offers the following benefits for this position, subject to applicable eligibility requirements: medical insurance, dental insurance, vision insurance, 401(k) retirement plan, life insurance, longterm disability insurance, shortterm disability insurance, paid parking/public transportation, paid time off, paid sick and safe time, hours of paid vacation time, weeks of paid parental leave, paid holidays annually as applicable.