Benefit Verification Specialist (Health Insurance, USA), at Talent Pro · Bengaluru (Bangalore) · 1 - 4 years · ₹4L - ₹6L / yr · Bootstrapped · Posted 24 Oct 2025
Strong Benefit/ Insurance Verifcation Specialists profile
Mandatory (Experience 1) – Must have minimum 6 months of hands-on experience in US healthcare insurance eligibility and benefits verification
Mandatory (Experience 2) – Must have worked on payer portals such as Availity, NaviNet, Aetna, UHC, or equivalent.
Mandatory (Experience 3) – Strong understanding of insurance types — Commercial, Medicare, Medicare Advantage, Medicaid, Managed Medicaid, HMO/PPO, VA, DoD, etc.
Mandatory (Experience 4) – Experience in verifying deductibles, co-pay/coinsurance, prior authorization requirements, network status, and J-code/CPT/HCPCS-specific benefits.
Mandatory (Experience 5) – Ability to accurately document benefit details and maintain data in internal systems (CRM, RCM, or EMR platforms)
Manadatory (Skills) - Good communication skills
Shubham Vishwakarma
Full Stack Developer - Averlon
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Key Responsibilities
● Verify client documents and evidence for accuracy, completeness, and compliance with company standards.
● Communicate effectively with clients to clarify discrepancies, request additional documentation, or provide updates.
● Maintain organized records of verification statuses and client interactions.
● Collaborate with internal teams to resolve documentation or process-related issues.
● Prepare and maintain reports summarizing verification outcomes.
● Manage daily tasks efficiently to meet deadlines and maintain workflow consistency.
Key Responsibilities
● Verify client documents and evidence for accuracy, completeness, and compliance with company standards.
● Communicate effectively with clients to clarify discrepancies, request additional documentation, or provide updates.
● Maintain organized records of verification statuses and client interactions.
● Collaborate with internal teams to resolve documentation or process-related issues.
● Prepare and maintain reports summarizing verification outcomes.
● Manage daily tasks efficiently to meet deadlines and maintain workflow consistency.
Key Requirements
Education: Bachelor's degree in any discipline with a strong academic record.
Experience: Freshers are welcome to apply.
Candidates with 6 months or more of experience in any field are also eligible; however, prior experience in backend operations, document verification, or customer support roles will be preferred.
Technical Skills:
● Proficiency in Microsoft Excel and basic computer applications.
● Familiarity with documentation tools and verification processes.
Communication Skills:
● Strong verbal and written communication in English.
● Ability to handle client communication professionally and clearly.
Other Skills:
● Excellent attention to detail and accuracy.
● Strong problem-solving and time management abilities.
● Willingness to work early morning shifts (5:00 AM – 2:00 PM IST).
Key Responsibilities:
- Process insurance claims accurately as per defined procedures and guidelines.
- Review and investigate claims and take appropriate action based on process requirements.
- Handle customer calls and provide appropriate assistance.
- Ensure compliance with established policies, procedures, quality standards, and audit parameters.
- Meet defined SLA, quality, productivity, and performance targets.
- Maintain accuracy and attention to detail while processing claims.
- Take ownership of assigned tasks and deliverables.
- Coordinate effectively with team members, supervisors, and relevant departments.
- Maintain regular attendance and follow shift schedules and organizational policies.
- Continuously develop process knowledge and improve skills.
- Maintain professional communication and relationships with internal and external stakeholders.
Key Skills:
English Communication | Customer Service | Claims Processing | Attention to Detail | Problem Solving | Teamwork | Process Adherence | Time Management | Quality & SLA Management
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Full Stack Developer - Averlon