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