Verification of Benefits, Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Conduct timely and precise verification of benefits (VOBs) for all incoming clients across Detox, Residential, PHP, IOP, and OP levels of care.

• Verify coverage, benefit limitations, co-pays, deductibles, out-of-pocket maximums, exclusions, and pre-authorization requirements with each payer.

• Record VOB findings in designated tracking systems and update the client's EMR face sheet with complete supporting documentation.

• Communicate confirmed benefits clearly and promptly to admissions, billing, and clinical teams to ensure smooth intake and continuous care coordination.

• Perform bi-weekly re-verification of all active client insurance policies on the 1st and 16th of each month, identifying and addressing changes, lapses, or terminations.

• Monitor and track COBRA and Marketplace premium payments for active clients on those coverage types, informing any lapses or pending payments that may impact ongoing coverage.

• Keep meticulous documentation of premium statuses and any outreach or actions taken with clients or internal teams.

• Audit client EMR face sheets for accurate and complete insurance information during periods of lower volume.

• Enter client admission and discharge data into the billing system when the Hybrid Billing Coordinator is unavailable or at capacity.

• Assist with initial claim follow-ups for basic eligibility denials or coverage mismatches as required.

• Upload VOB documentation to the client's EMR face sheet in collaboration with the Hybrid Billing/VOB Specialist.

• Complete special assignments and additional duties as requested by the supervisor.

• Uphold HIPAA compliance and maintain patient confidentiality at every stage of the workflow.

⛳️ Requirements

• Previous hands-on experience with insurance verification of benefits in a US healthcare environment.

• Strong understanding of US commercial insurance (BCBS, Aetna, Cigna, UHC, Humana) and government payers (Medicare, Medicaid, Tricare), including pre-authorization processes.

• Direct experience utilizing an EMR system to update face sheets and document insurance information.

• Familiarity with COBRA continuation coverage and Affordable Care Act Marketplace plans, and how premium payment status influences active coverage.

• Exceptional attention to detail with the ability to identify missing or contradictory benefit information.

• Proficient verbal and written communication skills in English, including comfort in phone interactions with US payers and asynchronous written handoffs to internal teams.

• Capability to work independently, prioritize daily tasks, and meet turnaround expectations in a fast-paced setting.

• Proven awareness of HIPAA regulations and respect for patient confidentiality.

• Reliable home internet access, a quiet remote work environment, and willingness to align with US Mountain Time business hours.

• VOB experience specifically in behavioral health, mental health, or substance use treatment settings (Preferred).

🏝️ Benefits

• Fully remote, full-time position with a US-based behavioral health team.

• Compensation of USD $6/hour.

• Clearly defined ownership of the VOB workflow with a transparent path to broader revenue cycle responsibilities.

• A team that prioritizes accuracy, asynchronous clarity, and individuals who follow through without needing reminders.