Benefit/ Insurance Verifcation Specialists

Experience Required

Key Responsibilities

• Perform insurance verification and eligibility checks for commercial and government payers (e.g., Medicare, Medicare Advantage, Medicaid, Managed Medicaid, VA, DoD).
• Validate coverage details including deductibles, co-pay/coinsurance, network status, referrals, prior authorization requirements, and J-code/CPT-code specific benefits.
• Contact payer representatives via phone or payer portals as needed.
• Push back on payer based on previous experience.
• Accurately document findings in internal systems.
• Collaborate with internal teams to resolve missing or mismatched data.
• Collaborate with technology teams to improve data/systems.
• Ensure timely completion of verifications with high accuracy and within defined SLAs.
  

• 1+ years of experience in US healthcare insurance verification
• Familiarity with payer portals (e.g., Availity, Navinet, Aetna, UHC)
• Understanding of insurance types (commercial, Medicare, Medicaid, HMO/PPO, etc.)
• Working knowledge of CPT codes, HCPCS, and payer-specific benefits rules
• Strong attention to detail and ability to document accurately
• Proficient in written and spoken English
  

Good To Have

• Experience in specialty pharmacy, oncology, infusion therapy, or behavioral health
• Background working with RCM platforms, EMRs, or AI-based automation tools
  

• Be part of a team solving critical problems in healthcare automation
• High-ownership role in a startup culture with mentorship and fast learning
• Work closely with product and engineering teams building cutting-edge AI agents
• Contribute to improving access to care for patients across the U.S.