We're looking for a Benefits Verification Specialist to join our operations team in Bangalore. You'll verify insurance benefits for patients receiving specialty care in the US, working closely with payers, internal teams, and technology stakeholders. This is a full-time, in-office role with partial overlap with US business hours.
Open roles
Specialist
1–4 years of experience
Team Lead
5–7 years of experience
Key responsibilities
- Perform eligibility and benefits verification for commercial and government payers — including Medicare, Medicare Advantage, Medicaid, Managed Medicaid, VA, and DoD.
- Validate coverage details: 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 decisions based on experience.
- Accurately document all findings in internal systems.
- Collaborate with internal teams to resolve missing or mismatched data.
- Work with technology teams to improve workflows and data systems.
- Complete verifications accurately and on time, in line with defined SLAs.
Requirements
- 1+ years of experience in US healthcare insurance verification.
- Familiarity with payer portals such as Availity, Navinet, Aetna, and UHC.
- Understanding of insurance types: commercial, Medicare, Medicaid, HMO/PPO, and others.
- Working knowledge of CPT codes, HCPCS, and payer-specific benefit rules.
- Strong attention to detail with the ability to document accurately.
- Proficient in written and spoken English.
Bangalore – On-site, 5 days Night shift: 6:30 PM – 7:30 PM IST (9 hrs)US healthcare operations.
Pay: ₹300,000.00 - ₹650,000.00 per year
Application Question(s):
- Do you have Exp in Benefit Verification or Prior Authorization? - YES/NO
- Ready to work 5 Days working from Office (Bangalore Location) (Yes/No)
Work Location: In person
