Eligibility and Benefits Verification Specialist

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đŸ”„ 23 minutes ago

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RCM Staff LLC

11 - 50 employees

Founded 2024

đŸ„ Healthcare

🎯 Recruiter

đŸ€ 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 insurance eligibility before scheduled sessions, confirming active coverage, plan type, copay, coinsurance, and deductible ‱ Verify behavioral health benefits and identify carve-outs managed by separate payers, such as Optum, Carelon, Magellan, and Evernorth ‱ Track session limits and re-authorization needs, flagging caps and benefit maximums before they lapse ‱ Confirm telehealth coverage by payer, plan, and U.S. state ‱ Complete daily verification runs for upcoming appointments before the schedule opens ‱ Contact payers through portals and by phone to confirm details that require follow-up ‱ Document eligibility, benefit details, authorization numbers, and effective dates directly in the practice's EHR ‱ Escalate coverage issues and discrepancies to the practice team promptly ‱ Protect patient information and follow HIPAA requirements

🎯 Requirements

‱ At least 1 year of experience with U.S. healthcare insurance, including eligibility and benefits verification ‱ Experience initiating and tracking prior authorizations ‱ Familiarity with commercial insurance and government health plans ‱ 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

đŸ–ïž Benefits

‱ Health insurance ‱ Flexible work arrangements ‱ Professional development opportunities

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