Team Lead-Benefit Verification Specialist (US Health Insurance)

Team Lead – Benefit Verification Specialist (Health Insurance)

Bengaluru, Domlur (Work From Office)
Full-time | Rotational Night Shifts | Max Notice Period: 60 Days

About the Role
Hiring for a client in the US healthcare automation (product) space.
We are looking for a Team Lead – Benefit Verification Specialist with strong experience in US health insurance eligibility and benefits verification, along with proven team-handling capabilities.

Responsibilities

• Verify eligibility and benefits across commercial and government insurance plans
• Validate deductibles, co-pay/coinsurance, prior authorization requirements, network status, J-codes, CPT, and HCPCS benefits
• Document verification details accurately in CRM/RCM/EMR systems
• Work through payer portals such as Availity, NaviNet, Aetna, UHC, and others
• Lead a verification team, monitor performance, and ensure SLA adherence
• Coordinate with cross-functional teams to improve processes and resolve issues
• Maintain accuracy, compliance, and turnaround time standards

Mandatory Requirements

• Minimum 4 years US healthcare eligibility and benefits verification
• Minimum 2 years of team-handling experience
• Strong knowledge of insurance types: Commercial, Medicare, Medicare Advantage, Medicaid, Managed Medicaid, HMO/PPO, VA, DoD
• Experience verifying deductibles, co-pay/coinsurance, prior auth, J-codes, CPT, and HCPCS benefits
• Proficiency with payer portals such as Availity, NaviNet, Aetna, UHC
• Strong documentation and communication skills
• Comfortable with 5 days WFO and rotational night shifts (5:30 PM – 6:50 AM IST)

Preferred Experience

• Specialty pharmacy, oncology, infusion therapy, or behavioral health benefit verification

Location
Domlur, Bengaluru (Work From Office)

Job Type: Full-time

Pay: ₹66,000.00 - ₹80,000.00 per month

Work Location: In person