Benefits Verification Specialist

🔥 1 minute ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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

CareMetx, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

💼 Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

CareMetx, LLC is a company that specializes in transforming patient access to specialty therapeutics by reducing the time to therapy. They offer a digital Hub service that addresses emotional, financial, and clinical barriers for patients, aiming to improve treatment timelines and ongoing therapy use. CareMetx provides high-touch support and utilizes advanced technology to offer solutions for access, affordability, and adherence, benefiting both patients and healthcare providers. They partner with specialty pharmaceutical brands, healthcare providers, and hospital systems to enhance patient outcomes.

📋 Description

• Contact insurance companies to verify patient-specific benefits for client programs • Ask appropriate questions regarding patient benefits • Complete data entry and/or appropriate forms to document benefits coverage • Review patient insurance information needed to complete benefit verification • Triage cases with missing information to the appropriate program associate • Precisely document patient coverage, cost share, and access/provider options for various payer plans • Identify restrictions and details for expediting patient access • Document and initiate prior authorization processes and claims appeals when applicable • Complete quality review of work when finalizing products • Report reimbursement trends and delays to management • Perform related duties and special projects as assigned • Apply company policies and procedures to resolve a variety of issues

🎯 Requirements

• High school diploma or GED required • Minimum of two (2) years of directly related and progressively responsible experience in customer service, medical billing and coding, benefits verification, healthcare, business administration, or similar vocations • Equivalent combination of education and experience will be considered • MUST HAVE FUSION/SALESFORCE EXPERIENCE • Advanced customer service experience • Proficient Windows-based experience, including data entry/typing fundamentals • Proficient with Microsoft Outlook, Word, and Excel • Strong interpersonal skills and professionalism • Independent problem-solving and decision-making ability • Robust analytical skills • Strong attention to detail • Effective written and verbal communication • Familiarity with verification of insurance benefits preferred • Flexibility and ability to adapt to changing work situations • Must be flexible on schedule and hours • Some travel may be required • Ability to regularly sit and occasionally lift or move up to 10 pounds

🏖️ Benefits

• Equal employment opportunity employer • Reasonable accommodations for individuals with disabilities • Human review of AI-assisted recruiting and employment decisions