Benefit Assistant

Job Title : Benefit Verification Specialist (Health Insurance, USA) Location : Bengaluru (Onsite – 5 Days Work from Office) Experience : 1 to 4 years Shift : Rotational Night Shifts (5 : 30 PM – 6 : 50 AM IST) About the Role We’re looking for a Benefit Verification Specialist with hands-on experience in US healthcare insurance eligibility and benefits verification. You’ll be part of the growing operations team, supporting patients receiving specialty care across the U.S. This is a full-time, in-office role based in Bengaluru, with partial overlap with US hours. Key Responsibilities Perform insurance eligibility and benefit verification for Commercial and Government payers (Medicare, Medicare Advantage, Medicaid, Managed Medicaid, VA, DoD, etc.). Verify deductibles, co-pay / coinsurance, prior authorization requirements, network status, and J-code / CPT / HCPCS-specific benefits. Utilize payer portals such as Availity, NaviNet, Aetna, UHC, and others to confirm benefit details. Contact payer representatives via phone or portal when needed and push back confidently based on prior experience. Accurately document and maintain benefit data in internal systems (CRM / RCM / EMR). Collaborate with internal teams to resolve missing or mismatched data and improve processes. Ensure timely, accurate completion of verifications within defined SLAs. Mandatory Requirements Minimum 6 months of hands-on experience in US healthcare insurance eligibility and benefit verification. Proven experience with payer portals (Availity, NaviNet, Aetna, UHC, or equivalent). Strong understanding of insurance types — Commercial, Medicare, Medicaid, HMO / PPO, Managed Medicaid, VA, DoD, etc. Experience verifying deductibles, co-pay / coinsurance, prior auth requirements, and CPT / J-code benefits. Excellent documentation accuracy and familiarity with CRM, RCM, or EMR platforms. Good communication skills (verbal and written). Preferred Experience Prior exposure to specialty pharmacy, oncology, infusion therapy, or behavioral health benefit verification .