About the Role
We are hiring a Benefits Verification Specialist to join our growing healthcare operations team at 100ms.
This role sits at the intersection of US healthcare operations and technology, where you'll play a critical part in verifying patient insurance benefits and enabling seamless access to care. You will work closely with internal teams and contribute to improving operational workflows in a fast-paced environment.
Key Responsibilities
- Perform insurance eligibility & benefits verification for US patients (Commercial, Medicare, Medicaid, etc.)
- Validate key coverage details: deductibles, co-pay, coinsurance, network status, referrals, prior authorization
- Verify CPT / HCPCS / J-code-specific benefits
- Interact with payer representatives via calls and payer portals
- Accurately document and maintain data in CRM / RCM / EMR systems
- Collaborate with internal teams to resolve data gaps and discrepancies
- Ensure high accuracy, productivity, and SLA adherence
- Identify opportunities to improve processes and system efficiency
Ideal Candidate
- 14 years of experience in US Healthcare Insurance Verification / RCM
- Minimum 6 months hands-on experience in eligibility & benefits verification
- Strong understanding of:
- Commercial, Medicare, Medicare Advantage
- Medicaid, Managed Medicaid, HMO/PPO, VA, DoD
- Experience verifying:
- Deductibles, co-pay, coinsurance
- Prior authorization requirements
- Network status and CPT/HCPCS/J-code benefits
- Comfortable with US calling (payer interactions)
- Strong communication, attention to detail, and documentation skills
Preferred
- Experience in specialty pharmacy, oncology, infusion therapy, or behavioral health
- Exposure to complex or high-value benefit verification cases
Location & Work Details
- Bangalore (In-office)
- Full-time role
- Partial overlap with US working hours
Why Join Us
- Work on critical healthcare workflows impacting patients in the US
- Be part of a high-growth, fast-paced startup environment
- High ownership with strong learning and growth opportunities
- Collaborate with cross-functional teams including product & technology
