Benefits Support Specialist

Position Summary The Benefits Verification Specialist is responsible for conducting outbound calls to insurance carriers to manually verify patient or client insurance benefits. Based on the outcome of each verification call, this individual accurately routes or advances the case through the appropriate workflow pathway. Key Responsibilities Place outbound calls to insurance carriers and navigate payer phone systems to reach eligibility and benefits representatives Verify active coverage and obtain detailed benefits information including deductibles, copays, coinsurance, out-of-pocket maximums, prior authorization requirements, and in/out-of-network benefit levels Accurately document all information obtained during each call, including reference numbers, representative names, and call timestamps Interpret call outcomes and apply decision criteria to move each case to the correct next step in the workflow (e.g., eligible for services, requires prior auth, inactive/terminated coverage, patient financial responsibility assessment, denial routing) Identify discrepancies between payer-reported benefits and information on file and escalate appropriately Meet daily productivity and qualit