Benefit Verification Specialist (Health Insurance), 100ms

Benefit Verification Specialist (Health Insurance, USA), 100ms

JobID : 6844

Experience : 1-4 YOE

Outstation Candidates : Allowed

Max Notice Period : 60 Days

Working Days : 5 days/Week

Location : Domlur, Bengaluru

Review Criteria

Mandatory

? Strong Benefit/ Insurance Verifcation Specialists profile

? Mandatory (Experience 1) Must have minimum 6 months of hands-on experience in US healthcare insurance eligibility and benefits

verification

? Mandatory (Experience 2) Must have worked on payer portals such as Availity, NaviNet, Aetna, UHC, or equivalent.

? Mandatory (Experience 3) Strong understanding of insurance types Commercial, Medicare, Medicare Advantage, Medicaid,

Managed Medicaid, HMO/PPO, VA, DoD, etc.

? Mandatory (Experience 4) Experience in verifying deductibles, co-pay/coinsurance, prior authorization requirements, network

status, and J-code/CPT/HCPCS-specific benefits.

? Mandatory (Experience 5) Ability to accurately document benefit details and maintain data in internal systems (CRM, RCM, or

EMR platforms)

? Mandatory (Skills) - Good communication skills (Must have calling experience to US audience for claims)

Preferred

? Preferred (Experience) Prior experience in specialty pharmacy, oncology, infusion therapy, or behavioral health benefit verification.

Preferred Companies

ACN Healthcare, Omega Healthcare, Global RCP, Med billing Experts, Ncare Technology, Medsoft India Pvt

Ltd, Companies - AssistRx, UnitedHealth Group, Sunknowledge Services Inc., Amazon, Omega Healthcare

Management Services, Ascent Business Solutions, Pacific Global Inc., MedRCM360, IKS Health, Care365 SOL ,

INC, ACREV SOLUTIONS, MyOffice Answer India PVT. LTD., Ambit Global Solution, Credence Global

Solutions, JSD MEDICAL LTD, Advantum Health, iFedora Services Pvt Ltd, Fedora Solutions, AGS Health,

Elite RCM Pvt Ltd, QWay Technologies, Gack Billing Services, First Insight Corporation, Fortrea,

EXPRIMUNT MEDICAL BILLING PVT LTD, AAA Surgery Center, Cognizant , Geo professional services

LLC, US medical Billing, ACN Healthcare RCM Services Pvt Ltd, CorroHealth, Unify Healthcare Services

Job Specific Criteria

? CV Attachment is mandatory

? Are you comfortable working 5 days WFO, including rotational night shifts (5:30 PM 6:50 AM IST)

? How many years of experience do you have in US healthcare insurance eligibility and benefits verification

? Which payer portals have you worked on (e.g., Availity, NaviNet, Aetna, UHC, etc.)

? Rate Communication Skills (Out of 5)

? Do you have team lead experience (How many years and team size you have led)

? Do you have calling experience for healthcare benefits

? If you don't have calling experience, are you ok to learn and do calling

Benefit Verification Specialist (Health Insurance, USA), 100ms

Healthcare Design

Customer Relationship Management (CRM)

About 100ms

Health

100ms is building AI agents that automate complex patient access workflows in U.S. healthcare starting with benefits

verification,

prior authorization, and referral intake in specialty pharmacy. We help care teams reduce delays and administrative burden so that

patients can start treatment faster. Our automation platform combines deep healthcare knowledge with LLM-based agents and

robust

ops infrastructure. You'll be joining a specialized team at 100ms focused on healthcare automation using AI.

Role & Responsibilities

We're hiring a Benefits Verification Specialist with 14 years of experience in US health insurance eligibility and benefits verification. You'll be

part of our operations team, helping verify insurance benefits for patients receiving speciality care in the U.S.

This is a full-time, in-office role based in Bangalore, with partial overlap with US hours.

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.

Ideal Candidate

? 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

Perks, Benefits and Work Culture

? 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.