Insurance Benefits Verification Specialist

CareMetx, LLC; United States; Remote; USD 25,000 - 39,000; Full time

Job summary

CareMetx is seeking a Benefits Verification Specialist to verify patient benefits with insurance payers and document coverage for client programs. You will confirm eligibility, cost share, and access options while requesting any missing information.

This role requires at least two years of related experience, strong data entry skills, and proficiency with Fusion and Salesforce. You will collaborate with teams to expedite access and ensure accurate, timely documentation.

Qualifications

• Minimum 2 years related experience in customer service, medical billing or benefits verification.
• Bachelor’s degree preferred; equivalent combination of education and experience considered.
• Must have Fusion and Salesforce experience.

Responsibilities

• Review all patient insurance information needed to complete the benefit verification process.
• Triages cases with missing information to appropriate program associate.
• Verifies patient specific benefits and documents specifics for various payer plans including patient coverage, cost share, and access/provider options.
• Identifies any restrictions and details on how to expedite patient access.
• Could include documenting and initiating prior authorization process, claims appeals, etc.
• Completes quality review of work as part of finalizing product.
• Reports any reimbursement trends/delays to management.
• Performs related duties and special projects as assigned.
• Applies company policies and procedures to resolve a variety of issues.

Skills

Customer service experience

Attention to detail

Analytical skills

Written and verbal communication

Problem solving

Interpersonal skills

Education

Bachelor's degree preferred

Equivalent education and experience considered

Tools

Fusion

Salesforce

Job description

CareMetx is seeking a Benefits Verification Specialist to verify patient benefits with insurance payers and document coverage for client programs. You will confirm eligibility, cost share, and access options while requesting any missing information.

This role requires at least two years of related experience, strong data entry skills, and proficiency with Fusion and Salesforce. You will collaborate with teams to expedite access and ensure accurate, timely documentation.