Verification of Benefits Specialist

Responsibilities

• Verify insurance eligibility and benefits using Availity, VerifyTX, and payer portals, including direct carrier outreach when needed
• Interpret and document insurance coverage details including plan type (HMO/PPO/EPO/POS), deductibles, copays, coinsurance, and authorization requirements
• Enter accurate insurance and patient data into Salesforce and EHR systems
• Clearly communicate benefit details to internal teams and, when applicable, patients/families
• Coordinate with admissions, billing, and utilization review to ensure accurate financial clearance
• Manage high-volume VOB requests in a fast-paced admissions environment
• Ensure documentation accuracy, compliance, and HIPAA standards at all times

Required Experience

• 2+ years in VOB, insurance verification, revenue cycle, or patient access
• Strong knowledge of insurance plans (HMO, PPO, EPO, POS) and benefit structures
• Experience with Salesforce and payer portals (e.g., Availity)
• Understanding of revenue cycle flow (eligibility, verification, authorization, billing)
• Strong attention to detail and ability to work in a high-volume environment

Preferred Skills

• Behavioral health or substance use treatment experience
• Admissions, utilization review, or billing exposure
• Multi-payer insurance environment experience