Remote Benefits Verification & Eligibility Specialist

Baylor Genetics; Northern (KY); Hybrid; USD 42,000 - 66,000; Full time

Job summary

Baylor Genetics is seeking a Benefits Investigation & Eligibility Specialist to verify insurance eligibility and investigate benefits for genetic testing. You will confirm coverage details, collect payer requirements, and document findings to prevent reimbursement delays.

The role requires strong attention to detail, initiative, and ability to work with patients, provider offices, payers, and internal teams. Remote position with a focus on accuracy and timely information.

Qualifications

• High school diploma or equivalent.
• 2+ years in healthcare insurance verification, benefits investigation, patient access, revenue cycle, or related function.
• Working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans.
• Experience using payer portals, electronic eligibility tools, and healthcare or revenue cycle systems.

Responsibilities

• Verify active insurance coverage and payer requirements across multiple lines of coverage.
• Use payer portals and electronic tools to validate and correct information.
• Contact patients/provider offices to obtain missing data and resolve issues that delay testing or reimbursement.
• Investigate patient benefits including deductibles, copays, coinsurance, and network requirements.
• Identify prior authorizations and payer requirements; route cases with complete info.
• Document findings, references, and follow-up actions in the system.
• Communicate eligibility findings clearly to patients and internal teams without guarantees.
• Manage work queues, prioritize time-sensitive cases, and meet productivity/quality targets.
• Participate in training, quality reviews, and HIPAA/compliance activities.

Skills

Attention to detail

Communication

Problem solving

Organization

Data entry accuracy

Education

High school diploma or equivalent

Associate degree in healthcare administration

Tools

Quadax

Salesforce

Clearinghouses

Payer portals

Job description

Baylor Genetics is seeking a Benefits Investigation & Eligibility Specialist to verify insurance eligibility and investigate benefits for genetic testing. You will confirm coverage details, collect payer requirements, and document findings to prevent reimbursement delays.

The role requires strong attention to detail, initiative, and ability to work with patients, provider offices, payers, and internal teams. Remote position with a focus on accuracy and timely information.