Benefits Support Specialist

This is a fully remote position, open to applicants in Arizona, +25 more states.

📋 Description

• Make outbound calls to insurance providers and effectively navigate their phone systems to connect with eligibility and benefits representatives.

• Confirm active coverage and gather comprehensive benefits information, including deductibles, copays, coinsurance, out-of-pocket maximums, prior authorization requirements, and in/out-of-network benefit levels.

• Meticulously document all information acquired during each call, including reference numbers, names of representatives, and call timestamps.

• Analyze call results and apply decision criteria to progress each case to the appropriate next step in the workflow (e.g., eligible for services, requires prior authorization, inactive/terminated coverage, patient financial responsibility assessment, denial routing).

• Detect discrepancies between reported benefits from payers and the information on file, escalating issues as needed.

• Achieve daily productivity and quality benchmarks for call volume and documentation precision.

• Maintain a solid understanding of common insurance terminology, various plan types (HMO, PPO, EPO, HDHP), and specific payer requirements.

⛳️ Requirements

• Over 1 year of experience in medical billing, insurance verification, or a similar healthcare administrative role.

• At least 1 year of customer support experience (preferably in a call center environment).

• Knowledge of insurance benefits terminology and payer communication processes.

• Exceptional attention to detail and the ability to transcribe information accurately in real-time with minimal errors.

• Capability to independently evaluate call outcomes and implement routing logic without constant oversight.

• Comfortable handling high call volumes and navigating automated payer phone systems.

• Proficient in EHR/practice management software or comparable case management systems.

• Must possess a solid understanding of computers, hardware, networks, etc.

• Flexible and adaptable to rapid changes.

• Willing to give and receive feedback in a gracious and professional manner.

🏝️ Benefits

• Fully remote working environment available in the following states: AZ, CA, CO, FL, GA, IA, ID, IL, IN, MA, MI, MO, NC, NH, NJ, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV.

• Competitive compensation (commensurate with experience).

• Comprehensive benefits package (medical, dental, vision).

• 401(k).