Benefit Verification Specialist

Carolina Oncology Specialists has been providing compassionate, patient-centered care since 1983, delivering high-quality oncology and hematology services tailored to each individual's needs. Patients benefit from the convenience of receiving chemotherapy treatments in our clinics, along with expert diagnosis, treatment, and management of a wide range of blood disorders.

Why Join Us?

We are seeking talented, compassionate, and highly motivated individuals who are passionate about making a difference. At Carolina Oncology Specialists, you'll have the opportunity to support the meaningful work of community oncology while helping provide exceptional care and hope to the patients and families we serve. Join a team dedicated to clinical excellence, collaboration, and improving lives every day.

Job Description:

Job Title: Benefit Verification Specialist  
Department: RCM  
Location: Carolina Oncology Specialists-TBD  
Reports To: Billing Manager

Position Summary

The Benefit Verification Specialist is responsible for verifying patient insurance eligibility, benefits, and coverage prior to services being rendered . This role ensures accurate and timely benefit information to support patient care, financial counseling, and billing processes. The Benefit Verification Specialist plays a critical role in reducing claim denials, improving reimbursement outcomes, and enhancing the patient financial experience.

Key Responsibilities

- Verify patient insurance eligibility and benefits for all scheduled services

- Confirm coverage details including copays, deductibles, coinsurance, out-of-pocket maximums and network status

- Communicate benefit and coverage details to financial counselors, billing teams, and clinical staff

- Document all verification details accurately in the electronic health record (EHR) or practice management system

- Review payer responses to ensure completeness and accuracy of information obtained

- Work closely with scheduling, financial counseling, and prior authorization teams to ensure timely financial clearance

- Identify discrepancies in insurance coverage and resolve issues prior to services

- Notify patients or appropriate staff of coverage limitations , out of network status or potential financial responsibility

- Maintain knowledge of payer policies including Medicare, Medicaid, and commercial insurance plans

- Ensure compliance with HIPAA and organizational policies when handling patient information

- Assist in identifying trends in coverage issues or verification delays and escalate to leadership

Qualifications

Required:

- High school diploma or equivalent

- Minimum of 2–3 years of experience in patient access, insurance verification, or revenue cycle operations

- Knowledge of insurance plans including Medicare, Medicaid, and commercial payers

- Experience with EHR and practice management systems

- Strong attention to detail and organizational skills

- Excellent communication and customer service skills

Preferred:

- Experience in oncology or specialty healthcare setting

- Familiarity with prior authorization and financial counseling workflows

- Knowledge of payer portals and eligibility verification tools

Key Competencies

- High attention to detail and accuracy

- Strong analytical and problem-solving skills

- Effective communication and collaboration

- Time management and ability to meet deadlines

- Ability to manage multiple priorities in a fast-paced environment

- Patient-focused and service-oriented mindset

- Accountability and reliability

Working Conditions

- Primarily office-based or patient access environment

- Frequent interaction with staff, patients, and insurance payers

- Regular use of computers, phones, and payer systems

Physical Requirements

- Ability to sit for extended periods

- Ability to use standard office equipment, including computers and telephones