Benefits Verification Specialist

CareMetx, LLC

. Contact insurance companies to verify patient-specific benefits for client programs .

Posted 10/27/2026full-timeRemote • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in patient benefits verification, including proficiency in Fusion/Salesforce and Microsoft Office Suite. Strong analytical skills and attention to detail are essential for effective documentation and problem-solving in a healthcare environment.

Highest-signal resume keywords

Fusion/Salesforce ExperiencePatient Benefits VerificationCustomer Service ExperienceData Entry ProficiencyAnalytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical BillingCodingBenefits VerificationData EntryPrior Authorization ProcessesClaims AppealsQuality ReviewDocumentationReimbursement ReportingInsurance Information Review

Soft Skills

Interpersonal SkillsProblem-SolvingDecision-MakingAttention to DetailEffective Communication

Tools & Technologies

Microsoft OutlookMicrosoft WordMicrosoft ExcelWindows-Based Systems

Industry Keywords

HealthcareCustomer ServiceBusiness AdministrationInsurance BenefitsPatient Access

About the role

Key responsibilities & impact

Contact insurance companies to verify patient-specific benefits for client programs
Ask appropriate questions regarding patient benefits
Complete data entry and/or appropriate forms to document benefits coverage
Review patient insurance information needed to complete benefit verification
Triage cases with missing information to the appropriate program associate
Precisely document patient coverage, cost share, and access/provider options for various payer plans
Identify restrictions and details for expediting patient access
Document and initiate prior authorization processes and claims appeals when applicable
Complete quality review of work when finalizing products
Report reimbursement trends and delays to management
Perform related duties and special projects as assigned
Apply company policies and procedures to resolve a variety of issues

Requirements

What you’ll need

High school diploma or GED required
Minimum of two (2) years of directly related and progressively responsible experience in customer service, medical billing and coding, benefits verification, healthcare, business administration, or similar vocations
Equivalent combination of education and experience will be considered
MUST HAVE FUSION/SALESFORCE EXPERIENCE
Advanced customer service experience
Proficient Windows-based experience, including data entry/typing fundamentals
Proficient with Microsoft Outlook, Word, and Excel
Strong interpersonal skills and professionalism
Independent problem-solving and decision-making ability
Robust analytical skills
Strong attention to detail
Effective written and verbal communication
Familiarity with verification of insurance benefits preferred
Flexibility and ability to adapt to changing work situations
Must be flexible on schedule and hours
Some travel may be required
Ability to regularly sit and occasionally lift or move up to 10 pounds