Benefit Verification Specialist (Health Insurance, USA) at TalentXO · Bengaluru (Bangalore) · 1 - 6 years · ₹4L - ₹6L / yr · Profitable · Posted 23 Feb 2026
Role & Responsibilities
We’re hiring a Benefits Verification Specialist with 1–4 years of experience in US health insurance eligibility and benefits verification. You’ll be part of our operations team, helping verify insurance benefits for patients receiving speciality care in the U.S.
This is a full-time, in-office role based in Bangalore, with partial overlap with US hours.
Key Responsibilities:
- Perform insurance verification and eligibility checks for commercial and government payers (e.g., Medicare, Medicare Advantage, Medicaid, Managed Medicaid, VA, DoD).
- Validate coverage details including deductibles, co-pay/coinsurance, network status, referrals, prior authorization requirements, and J-code/CPT-code specific benefits.
- Contact payer representatives via phone or payer portals as needed.
- Push back on payer based on previous experience.
- Accurately document findings in internal systems.
- Collaborate with internal teams to resolve missing or mismatched data.
- Collaborate with technology teams to improve data/systems.
- Ensure timely completion of verifications with high accuracy and within defined SLAs.
Ideal Candidate
- Strong Benefit/ Insurance Verification 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) – Strong understanding of insurance types — Commercial, Medicare, Medicare Advantage, Medicaid, Managed Medicaid, HMO/PPO, VA, DoD, etc.
- Mandatory (Experience 3) – Experience in verifying deductibles, co-pay/coinsurance, prior authorization requirements, network status, and J-code/CPT/HCPCS-specific benefits.
- Mandatory (Experience 4) – Ability to accurately document benefit details and maintain data in internal systems (CRM, RCM, or EMR platforms)
- Mandatory (Experience 5) – Ability to accurately document benefit details and maintain data in internal systems (CRM, RCM, or EMR platforms)
- Mandatory (Skills) - Good communication skills (Must have calling experience to US audience for claims)
- Mandatory (Note) - Don't want post insurance verification profiles (Accounts receivables AR etc)
- Preferred (Experience) – Prior experience in specialty pharmacy, oncology, infusion therapy, or behavioral health benefit verification.
Perks, Benefits and Work Culture
- Be part of a team solving critical problems in healthcare automation
- High-ownership role in a startup culture with mentorship and fast learning
- Work closely with product and engineering teams building cutting-edge AI agents
- Contribute to improving access to care for patients across the U.S.
Shubham Vishwakarma
Full Stack Developer - Averlon
About TalentXO
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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
Job description:
Role Overview
We are hiring an Insurance Process Executive with 1–4 years of experience in insurance operations or back-office processing. The selected candidate will be responsible for managing end-to-end insurance processes including new business, renewals, endorsements, and claims support, while ensuring high accuracy and compliance with Australian insurance standards.
This role offers excellent exposure to international insurance processes and structured careergrowth opportunities.
Key Responsibilities
- New Business: Process new insurance policies, quotations, and compliance.
- Renewals: Handle renewal processing, prepare renewal schedules, and coordinate policy updates.
- Claims Support: Assist in claim lodgement, documentation collection, and follow-ups with relevant stakeholders.
- Endorsements: Manage policy modifications, updates, and mid-term changes.
- Compliance & Audit: Ensure accuracy of data entry and adherence to compliance and regulatory requirements as per Australian standards.
- Client Support: Respond to client queries, provide updates, and maintain professional communication with internal and external teams.
- Maintain proper records and documentation using internal systems and tools. Skills Required
- Strong communication skills (written and verbal).
- Good logical thinking and analytical ability.
- Strong attention to detail and accuracy in data handling.
- Proficiency in software tools such as Zoho CRM, MS Excel, Outlook, SharePoint, etc.
- Ability to work under deadlines and manage multiple tasks efficiently.
- Quick learner with adaptability to new processes and systems.
Eligibility Criteria
- 1–4 years of experience in insurance operations (with good knowledge of insurance class / transport insurance / Business Insurance), process executive roles, or back office support.
- Candidates with experience in the Australian insurance domain will be preferred.
- Commerce/Finance/Business background
Benefits:
- Commuter assistance
- Food provided
- Health insurance
- Internet reimbursement
- Leave encashment
- Paid sick time
- Paid time off
- Provident Fund
Work Location: In person
Follow CutshortShubham Vishwakarma
Full Stack Developer - Averlon