Remote Benefits Verification & Eligibility Specialist

Baylor Miraca Genetics Laboratories LLC; United States; Remote; USD 42,000 - 63,000; Full time

Job summary

Baylor Genetics is seeking a Benefits Investigation & Eligibility Specialist to verify patient insurance eligibility and investigate benefits for genetic and molecular diagnostic testing. The role confirms active coverage, identifies payer requirements, and documents findings to prevent reimbursement delays.

The ideal candidate works independently with strong attention to detail, communicates clearly with patients, provider offices, payers, and internal teams, and adheres to HIPAA and Baylor

Qualifications

• 2+ years in healthcare insurance verification, benefits investigation, or payer coordination.
• Experience with payer portals and healthcare systems.
• Ability to work independently and maintain HIPAA compliance.

Responsibilities

• Verify active insurance coverage across primary, secondary, and tertiary plans.
• Use payer portals and tools to validate coverage and resolve issues.
• Contact patients and provider offices to obtain missing information and escalate delays.
• Investigate patient benefits including deductibles, copays, coinsurance, and network requirements.
• Identify prior authorization and other payer requirements and route with complete info.
• Document findings and follow-up actions in the designated system.

Skills

Healthcare insurance verification

Benefits investigation

Attention to detail

Patient communication

Independent work

Time management

HIPAA compliance

Education

High school diploma or equivalent

Associate degree in healthcare administration

Tools

Payer portals

Clearinghouses

Salesforce

Quadax

Job description

Baylor Genetics is seeking a Benefits Investigation & Eligibility Specialist to verify patient insurance eligibility and investigate benefits for genetic and molecular diagnostic testing. The role confirms active coverage, identifies payer requirements, and documents findings to prevent reimbursement delays.

The ideal candidate works independently with strong attention to detail, communicates clearly with patients, provider offices, payers, and internal teams, and adheres to HIPAA and Baylor