Job description
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 provider group based in Wisconsin.
The specialist verifies patient insurance coverage and benefits ahead of scheduled visits, documents findings in the practice's EHR, and flags coverage issues to the practice before the appointment. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.
Key Responsibilities
Verify patient eligibility and active coverage for upcoming appointments using payer portals, Availity, and payer phone lines
Confirm behavioral health benefits including copay, coinsurance, deductible, out-of-pocket status, visit limits, and telehealth coverage
Identify behavioral health carve-outs and confirm the correct payer and claims-submission payer ID
Check whether prior authorization is required for scheduled services and note the requirement and status
Verify primary and secondary coverage and coordination of benefits
Document verification results in the practice's EHR using the standard note format, including the date benefits were quoted
Escalate coverage problems to the practice contact with a clear decision request before the visit
Complete assigned daily verification queues within the practice's turnaround times
Protect patient information and follow HIPAA requirements
Qualifications
At least 1 year of experience with U.S. healthcare insurance
Hands-on experience with eligibility and benefits verification
Familiarity with commercial insurance and government health plans, including Medicare and Medicaid
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, psychiatry, or mental health counseling practices
•Experience using PracticeQ (IntakeQ)
Familiarity with Wisconsin insurance plans, including Wisconsin Medicaid and BadgerCare Plus
Experience verifying behavioral health carve-outs, visit limits, and telehealth benefits
Schedule
•Full-time position
Must be available during Central Time business hours
Final schedule will be determined based on practice needs
Work Arrangement
•Remote
•Philippines-based applicants preferred
Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.