Eligibility and Benefits Verification Specialist - Valant (FL)
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AI Summary
The specialist is responsible for verifying insurance eligibility and behavioral health benefits for patients prior to their scheduled sessions. They must document all coverage details, authorization numbers, and session limits within the practice's EHR system.
This is a remote position.
Job Summary
RCM Staff BPO is hiring a full-time Eligibility and Benefits Verification Specialist to support a behavioral health practice based in Florida. The specialist verifies insurance coverage and behavioral health benefits before every session, working inside the practice's EHR so eligibility is confirmed ahead of each appointment. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans, including behavioral health benefits and payer carve-outs.
Key Responsibilities
- Verify insurance eligibility before scheduled sessions, confirming active coverage, plan type, copay, coinsurance, and deductible
- Verify behavioral health benefits and identify carve-outs managed by separate payers, such as Optum, Carelon, Magellan, and Evernorth
- Track session limits and re-authorization needs, flagging caps and benefit maximums before they lapse
- Confirm telehealth coverage by payer, plan, and U.S. state
- Complete daily verification runs for upcoming appointments before the schedule opens
- Contact payers through portals and by phone to confirm details that require follow-up
- Document eligibility, benefit details, authorization numbers, and effective dates directly in the practice's EHR
- Escalate coverage issues and discrepancies to the practice team promptly
- Protect patient information and follow HIPAA requirements
Qualifications
- At least 1 year of experience with U.S. healthcare insurance, including eligibility and benefits verification
- Experience initiating and tracking prior authorizations
- Familiarity with commercial insurance and government health plans
- Experience using payer portals and insurance websites
- Strong written and spoken English
- Excellent attention to detail and follow-up skills
- Ability to work independently and manage multiple patient accounts
- Reliable internet connection and a suitable remote workspace
Preferred Qualifications
- Experience supporting behavioral health, mental health, or telehealth practices
- Experience verifying behavioral health benefits and carve-outs (Optum, Carelon, Magellan, Evernorth)
- Experience using Valant EHR
- Familiarity with Florida insurance plans (Aetna, Cigna/Evernorth, UHC/Optum, Florida Blue, Medicare)
- Experience confirming telehealth coverage and tracking session limits and re-authorizations
Schedule
- Full-time position
- Must be available during U.S. Eastern Time business hours (Monday–Friday)
- Final schedule will be determined based on practice needs
Work Arrangement
- Remote
- Philippines-based applicants preferred
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