Team Lead-Benefit Verification Speicalist

1 hour ago

Bengaluru, Karnataka, India CG-VAK Software & Exports Ltd. Full time ₹ 1,80,000 - ₹ 15,00,000 per year

Role & Responsibilities

We're hiring a Benefits Verification Specialist with 5–8 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

  • 4+ 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.

Skills: erm,health,medicare,uhc,us healthcare,aetna,payer,data,medicaid,insurance

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