Benefit Verification Specialist

Astera Cancer Care; Hickory (NC); On-site; USD 38,000 - 52,000; Full time

Job summary

Carolina Oncology Specialists is seeking a Benefit Verification Specialist to verify patient insurance eligibility and benefits before services are rendered. The role supports accurate financial clearance for patients and collaborates with billing and clinical staff to minimize claim denials.

Responsibilities include confirming coverage specifics, communicating information to financial counselors, and ensuring HIPAA compliance in all patient data handling.

Qualifications

• 2–3 years of experience in patient access, insurance verification, or revenue cycle operations.
• Knowledge of Medicare, Medicaid, and commercial payers.
• Experience with EHR and practice management systems.

Responsibilities

• Verify patient insurance eligibility and benefits for all scheduled services.
• Confirm coverage details including copays, deductibles, coinsurance, and network status.
• Communicate benefit details to financial counselors and billing teams.
• Document verification details in the EHR or practice management system and ensure accuracy.
• Maintain HIPAA compliance when handling patient information.

Skills

Insurance verification

Patient access

EHR

Communication

Time management

Education

High school diploma or equivalent

Tools

EHR

Practice management systems

Job description

Carolina Oncology Specialists has been providing compassionate, patient-centered care since 1983, delivering high-quality oncology and hematology services tailored to each individual's needs. Patients benefit from the convenience of receiving chemotherapy treatments in our clinics, along with expert diagnosis, treatment, and management of a wide range of blood disorders.Why Join Us?We are seeking talented, compassionate, and highly motivated individuals who are passionate about making a difference. At Carolina Oncology Specialists, you'll have the opportunity to support the meaningful work of community oncology while helping provide exceptional care and hope to the patients and families we serve. Join a team dedicated to clinical excellence, collaboration, and improving lives every day.Job Description:Job Title: Benefit Verification SpecialistDepartment: RCMLocation: Carolina Oncology Specialists-TBDReports To: Billing ManagerPosition SummaryThe Benefit Verification Specialist is responsible for verifying patient insurance eligibility, benefits, and coverage prior to services being rendered. This role ensures accurate and timely benefit information to support patient care, financial counseling, and billing processes. The Benefit Verification Specialist plays a critical role in reducing claim denials, improving reimbursement outcomes, and enhancing the patient financial experience.Key ResponsibilitiesVerify patient insurance eligibility and benefits for all scheduled servicesConfirm coverage details including copays, deductibles, coinsurance, out-of-pocket maximums and network statusCommunicate benefit and coverage details to financial counselors, billing teams, and clinical staffDocument all verification details accurately in the electronic health record (EHR) or practice management systemReview payer responses to ensure completeness and accuracy of information obtainedWork closely with scheduling, financial counseling, and prior authorization teams to ensure timely financial clearanceIdentify discrepancies in insurance coverage and resolve issues prior to servicesNotify patients or appropriate staff of coverage limitations, out of network status or potential financial responsibilityMaintain knowledge of payer policies including Medicare, Medicaid, and commercial insurance plansEnsure compliance with HIPAA and organizational policies when handling patient informationAssist in identifying trends in coverage issues or verification delays and escalate to leadershipQualificationsRequired:High school diploma or equivalentMinimum of 2–3 years of experience in patient access, insurance verification, or revenue cycle operationsKnowledge of insurance plans including Medicare, Medicaid, and commercial payersExperience with EHR and practice management systemsStrong attention to detail and organizational skillsExcellent communication and customer service skillsPreferred:Experience in oncology or specialty healthcare settingFamiliarity with prior authorization and financial counseling workflowsKnowledge of payer portals and eligibility verification toolsKey CompetenciesHigh attention to detail and accuracyStrong analytical and problem-solving skillsEffective communication and collaborationTime management and ability to meet deadlinesAbility to manage multiple priorities in a fast-paced environmentPatient-focused and service-oriented mindsetAccountability and reliabilityWorking ConditionsPrimarily office-based or patient access environmentFrequent interaction with staff, patients, and insurance payersRegular use of computers, phones, and payer systemsPhysical RequirementsAbility to sit for extended periodsAbility to use standard office equipment, including computers and telephones