Benefits Investigation Specialist

Job Summary

Verifying patient insurance eligibility and investigating benefits for genetic and molecular diagnostic testing, the full-time Benefits Investigation Specialist will work remotely to ensure accurate coverage information and resolve discrepancies to facilitate timely reimbursement.

Key responsibilities

• Verify active insurance coverage and confirm member details using payer portals and electronic eligibility tools
• Contact patients and provider offices to obtain missing or corrected insurance information and escalate unresolved issues
• Document benefit findings and communicate eligibility information clearly to patients and internal teams

Required qualifications

• High school diploma or equivalent
• 2+ years of experience in healthcare insurance verification, benefits investigation, or related functions
• Working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans
• Experience using payer portals and healthcare or revenue cycle systems
• Strong problem-solving skills and attention to detail in documentation and follow-up