**Role & seniority: ** Benefits Verification Specialist (1–4 years); operations team

**Stack/tools: ** Internal systems (CRM/RCM/EMR); payer portals; phone-based communication with US payers

**Top 3 responsibilities: **

Verify patient insurance eligibility/benefits for US commercial & government payers (Medicare, Medicare Advantage, Medicaid, Managed Medicaid, VA, DoD)
Validate coverage specifics: deductibles, copay/coinsurance, network status, referrals, prior authorization, and J-code/CPT/HCPCS-specific benefits
Document results accurately in internal systems; resolve missing/mismatched data with internal teams and meet SLAs
Must-have skills:
- Minimum 6 months hands-on experience in US healthcare eligibility/benefits verification
- Strong knowledge of insurance types: Commercial, Medicare/MA, Medicaid/Managed Medicaid, HMO/PPO, VA, DoD
- Experience verifying deductibles, cost-sharing, prior auth, network status, and code-specific benefits
- Accurate documentation in CRM/RCM/EMR; strong communication including calling US payers
Nice-to-haves:
- Experience in specialty pharmacy, oncology, infusion therapy, or behavioral health benefit verification
- Experience improving data/systems with technology teams
Location & work type: Bangalore, in-office, with partial overlap with US hours; full-time

Full Description

Role & Responsibilities

We’re hiring a Benefits Verification Specialist with 1–4 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

Strong Benefit/ Insurance Verification 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) – Strong understanding of insurance types — Commercial, Medicare, Medicare Advantage, Medicaid, Managed Medicaid, HMO/PPO, VA, DoD, etc. Mandatory (Experience 3) – Experience in verifying deductibles, co-pay/coinsurance, prior authorization requirements, network status, and J-code/CPT/HCPCS-specific benefits. Mandatory (Experience 4) – Ability to accurately document benefit details and maintain data in internal systems (CRM, RCM, or EMR platforms) 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) Mandatory (Note) - Don't want post insurance verification profiles (Accounts receivables AR etc) Preferred (Experience) – Prior experience in specialty pharmacy, oncology, infusion therapy, or behavioral health benefit verification.

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.

Skills: eligibility,health,medicare,insurance verification,insurance,medicaid