Eligibility and Benefits Verification Specialist

🔥 15 hours ago

🇵🇭 Philippines – Remote

⏰ Full Time

🟢 Junior

✨ Benefits Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 15%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

RCM Staff LLC

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2024

🏥 Healthcare

🎯 Recruiter

🤝 B2B

Healthcare • Recruitment • B2B

RCM Staff LLC is a staffing company that provides HIPAA-trained, healthcare-focused medical billers, certified coders, A/R follow-up specialists, and medical virtual assistants based in the Philippines who work directly inside U. S. clients’ existing EHRs, clearinghouses, and payer portals. The company handles recruiting, onboarding, training, and oversight while clients retain operational control; service tiers range from Core (staff augmentation) to Plus (account management and KPIs) and Executive (managed QA and continuity planning). RCM Staff targets medical billing companies, physician practices (solo, group, behavioral health, primary care), and RCM vendors, and emphasizes compliance (BAA available), AAPC-certified leadership, and 18+ years of U. S. revenue cycle experience.

📋 Description

• Verify patient eligibility and active coverage for upcoming appointments using payer portals, Availity, and payer phone lines • Confirm behavioral health benefits including copay, coinsurance, deductible, out-of-pocket status, visit limits, and telehealth coverage • Identify behavioral health carve-outs and confirm the correct payer and claims-submission payer ID • Check whether prior authorization is required for scheduled services and note the requirement and status • Verify primary and secondary coverage and coordination of benefits • Document verification results in the practice's EHR using the standard note format, including the date benefits were quoted • Escalate coverage problems to the practice contact with a clear decision request before the visit • Complete assigned daily verification queues within the practice's turnaround times • Protect patient information and follow HIPAA requirements

🎯 Requirements

• At least 1 year of experience with U.S. healthcare insurance • Hands-on experience with eligibility and benefits verification • Familiarity with commercial insurance and government health plans, including Medicare and Medicaid • Experience using payer portals and insurance websites • Strong written and spoken English • Excellent attention to detail and follow-up skills • Ability to work independently and manage multiple patient accounts • Reliable internet connection and a suitable remote workspace • Must be available during Central Time business hours • Preferred: Experience supporting behavioral health, psychiatry, or mental health counseling practices • Preferred: Experience using PracticeQ (IntakeQ) • Preferred: Familiarity with Wisconsin insurance plans, including Wisconsin Medicaid and BadgerCare Plus • Preferred: Experience verifying behavioral health carve-outs, visit limits, and telehealth benefits

🏖️ Benefits

• Remote position • Full-time employment • Remote work arrangement • Philippines-based applicants preferred