Medical Benefits Verification Specialist
OVERVIEW
We are recruiting on behalf of our client for a Medical Benefits Verification Specialist. This is a fully remote position supporting a US-based healthcare client, with the successful candidate required to work aligned to Eastern Standard Time (EST) business hours. The specialist will be responsible for verifying patients' insurance benefits and ensuring accurate coverage information is in place before services are rendered.
This is an urgent hire. Candidates with direct Verification of Benefits (VOB) experience within a US healthcare environment are strongly encouraged to apply.
KEY RESPONSIBILITIES
- Verify patient insurance eligibility and benefits with US-based insurance providers prior to service
- delivery
- Contact insurance companies directly via phone and payer portals to confirm coverage details, deductibles, co-pays, and out-of-pocket costs relevant internal teams current
- Identify prior authorization requirements or coverage limitations and communicate these to the
- relevant internal teams
- Accurately document all verified benefits information within the client's designated system
- Follow up on outstanding verifications to ensure no delays in patient service timelines
- Liaise with internal teams to resolve discrepancies and ensure patient records are complete and current
- Manage a high volume of verification requests while maintaining a consistent standard of accuracy
REQUIREMENTS
- Matric (Grade 12) as a minimum; a National Diploma or relevant NQF Level 6 qualification in
- healthcare administration, medical billing, or a related field is advantageous
- Demonstrated experience in Verification of Benefits (VOB) within a US healthcare environment
- Solid understanding of US health insurance plans, insurance terminology, and payer portals
- Experience verifying eligibility, authorizations, deductibles, co-pays, and out-of-pocket costs
- Reliable home office setup with stable internet connectivity to support consistent remote work
- Ability and willingness to work US Eastern Standard Time (EST) business hours
PREFERRED EXPERIENCE
- Prior experience working remotely for a US-based healthcare or medical billing client
- Familiarity with US payer portals such as Availity, NaviNet, or similar platforms
- Experience in a high-volume verification or medical billing environment
- Background in behavioral health, rehabilitation, or specialty healthcare settings
Work Location: Remote
