
Benefit Verification Specialist
2 weeks ago
About 100ms
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.
About the Role- 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.
- 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.
- 2+ 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
- Experience in specialty pharmacy, oncology, infusion therapy, or behavioral health
- Background working with RCM platforms, EMRs, or AI-based automation tools
- 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.
- This position is based at 100ms's Bangalore office. Employees are expected to work from the office five days a week, as in-office presence is essential to foster collaboration and strengthen company culture.
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