Benefit Verification Specialist

21 hours ago

Delhi, India TalentXO Full time

Role & ResponsibilitiesWe’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 Candidate1+ years of experience in  US healthcare insurance verificationFamiliarity 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 rulesStrong attention to detail and ability to document accuratelyProficient in written and spoken EnglishGood to Have:Experience in specialty pharmacy, oncology, infusion therapy, or behavioral healthBackground working with RCM platforms, EMRs, or AI-based automation toolsPerks, Benefits and Work CultureBe part of a team solving critical problems in healthcare automationHigh-ownership role in a startup culture with mentorship and fast learningWork closely with product and engineering teams building cutting-edge AI agentsContribute to improving access to care for patients across the U.S.

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