Verification of Benefits Specialist

The Verification of Benefits Specialist supports behavioral health and telehealth admissions by verifying insurance eligibility, interpreting benefit structures, documenting coverage details, and helping determine patient financial responsibility. This role works closely with admissions, utilization review, and billing teams to support accurate financial clearance and reduce downstream billing issues.

The position requires strong knowledge of insurance plan types, deductibles, copays, coinsurance, out-of-pocket maximums, authorization requirements, payer portals, Salesforce, EHR systems, and HIPAA-compliant documentation.

### Key Responsibilities

* Verify insurance eligibility and benefits
* Use Availity, VerifyTX, and payer portals
* Contact insurance carriers when needed
* Review HMO, PPO, EPO, and POS plan details
* Document deductibles, copays, coinsurance, and out-of-pocket maximums
* Identify authorization requirements
* Enter insurance and patient data into Salesforce
* Update EHR systems with benefit details
* Communicate benefit information to internal teams
* Communicate benefit information to patients or families when applicable
* Coordinate with admissions, billing, and utilization review teams
* Support financial clearance processes
* Manage high-volume VOB requests
* Maintain HIPAA compliance and documentation accuracy

### Requirements

* 2+ years VOB, insurance verification, revenue cycle, or patient access experience
* Strong knowledge of insurance plans and benefit structures
* Experience with Salesforce
* Experience with payer portals
* Availity experience
* Understanding of eligibility, verification, authorization, and billing workflows
* Strong attention to detail
* Ability to work in a high-volume environment
* Strong documentation skills
* HIPAA compliance awareness

### Preferred Qualifications

* Behavioral health experience
* Substance use treatment experience
* Admissions experience
* Utilization review exposure
* Billing experience
* Multi-payer insurance experience
* VerifyTX experience

### Benefits

Benefits not listed in posting.

### Phone Level Breakdown

* Payer outreach: Moderate
* Patient/family communication: Low to Moderate
* Internal team communication: Moderate
* Portal verification: High
* Salesforce documentation: High
* Financial clearance support: High

### Best Fit For

Candidates with experience in verification of benefits, insurance verification, patient access, behavioral health admissions, revenue cycle, financial clearance, payer portals, Availity, Salesforce documentation, utilization review support, and healthcare billing coordination.