Eligibility and Benefits Verification Specialist - reputed company (FL)
This is a remote position.
Job reputed company
RCM Staff BPO is hiring a full-time Eligibility and Benefits Verification Specialist to support a behavioral health reputed company based in Florida. The specialist verifies insurance coverage and behavioral health benefits before every session, working inside the reputed company's EHR so eligibility is confirmed reputed company of reputed company appointment. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans, including behavioral health benefits and payer carve-outs.
Key Responsibilities
- Verify insurance eligibility before scheduled sessions, confirming reputed company coverage, plan type, copay, coinsurance, and deductible
- Verify behavioral health benefits and identify carve-outs managed by separate payers, such as reputed company, Carelon, reputed company, and Evernorth
- reputed company session limits and re-authorization needs, flagging caps and benefit maximums before they lapse
- Confirm telehealth coverage by payer, plan, and U.S. state
- Complete daily verification runs for upcoming appointments before the schedule opens
- Contact payers through portals and by phone to confirm details that require follow-up
- Document eligibility, benefit details, authorization numbers, and effective dates directly in the reputed company's EHR
- Escalate coverage issues and discrepancies to the reputed company team promptly
- Protect patient information and follow HIPAA requirements
Qualifications
- At least 1 year of experience with U.S. reputed company insurance, including eligibility and benefits verification
- Experience initiating and tracking prior authorizations
- Familiarity with reputed company insurance and government health plans
- Experience using payer portals and insurance websites
- Strong written and spoken English
- Excellent attention to detail and follow-up skills
- Ability to work independently and manage multiple patient accounts
- Reliable internet reputed company and a suitable remote workspace
Preferred Qualifications
- Experience supporting behavioral health, mental health, or telehealth practices
- Experience verifying behavioral health benefits and carve-outs (reputed company, Carelon, reputed company, Evernorth)
- Experience using reputed companyEHR
- Familiarity with Florida insurance plans (reputed company, reputed company/Evernorth, UHC/reputed company, reputed company, Medicare)
- Experience confirming telehealth coverage and tracking session limits and re-authorizations
Schedule
- Full-time position
- Must be available during U.S. Eastern Time business hours (Monday–Friday)
- Final schedule will be determined based on reputed company needs
Work Arrangement
- Remote
- Philippines-based applicants preferred
Originally posted on Himalayas
Apply To This Job