Eligibility & Benefits Verification Representative

CF Outsourcing Solutions; Philippines; On-site; PHP 240,000 - 360,000; Full time

Job summary

CF Outsourcing Solutions is seeking a highly detail-oriented Eligibility & Benefits Verification Representative to support our Neurology practice. You will verify insurance coverage, benefits, and copays, and ensure patient records in the EHR are accurate.

This role emphasizes accuracy, confidentiality under HIPAA, and professional patient service, with responsibilities spanning chart maintenance, referrals, and data quality to improve access to care.

Qualifications

• Bachelor's degree or diploma in a medical-related field.
• Experience in Eligibility and Benefits Verification in healthcare.
• Knowledge of insurance verification, benefits investigation, and referrals.
• Experience with EHR systems.
• Detail-oriented with strong organizational and confidentiality skills.
• Excellent verbal and written communication.
• Patient-focused and able to deliver professional service.

Responsibilities

• Verify patient insurance eligibility, benefits, and copays; document in EHR.
• Update and maintain patient charts with accurate insurance and referral data.
• Review and attach referrals; ensure complete documentation and HIPAA compliance.
• Create new patient profiles and manage duplicates; maintain data integrity.
• Perform data verification and quality checks; safeguard patient information.

Skills

Attention to detail

Organizational skills

Verbal and written communication

Customer service

Confidentiality

HIPAA knowledge

Education

Healthcare-related degree

Tools

EHR systems

Job description

Job Summary

We are seeking a highly detail-oriented Eligibility & Benefits Verification Representative to join our fast-paced Neurology practice. The ideal candidate will be responsible for verifying patient insurance eligibility, benefits, and copay information; maintaining accurate patient records; and ensuring all documentation within the Electronic Health Record (EHR) system is complete and up to date.

This role plays a critical part in ensuring smooth patient access to care by validating insurance coverage, managing referrals, and supporting accurate patient chart maintenance.

Key Responsibilities

Insurance Verification

• Verify patient insurance eligibility, benefits, coverage details, and copay responsibilities.
• Ensure all insurance information is accurately documented in the EHR system.
• Confirm referral effective and termination dates as needed.

Patient Chart Management

• Update and maintain patient charts with accurate insurance and referral information.
• Flag patient accounts and charts when necessary to ensure proper follow-up.
• Enter copay amounts to be collected at the time of service.

Referral and Documentation Management

• Review, attach, and manage referrals within patient records.
• Ensure all supporting documentation is complete and accurately entered.
• Maintain compliance with documentation standards and office policies.

Patient Profile Administration

• Create new patient profiles when required.
• Identify, merge, and correct duplicate patient records.
• Maintain the integrity and accuracy of patient demographic and insurance information.

Quality and Compliance

• Safeguard confidential patient information in accordance with HIPAA and company policies.
• Perform data verification and quality checks to ensure record accuracy.
• Support a positive patient experience through excellent customer service and professionalism.

Qualifications

Required

• College graduate from a medical-related course or healthcare-related field.
• Previous experience in Eligibility and Benefits Verification within a healthcare setting.
• Working knowledge of insurance verification processes, benefits investigation, and referral management.
• Experience using Electronic Health Record (EHR) systems.
• Strong attention to detail and organizational skills.
• Excellent verbal and written communication skills.
• Ability to maintain confidentiality and handle sensitive patient information.
• Strong customer service skills and a patient-focused mindset.

Preferred

• Experience supporting Neurology, Specialty Care, or Physician Practice environments.
• Familiarity with medical insurance plans, authorizations, referrals, and copay collection processes.