Benefit Verification Specialist

Summary : The Benefit Verification Specialist is responsible for verifying, documenting, and maintaining accurate patient insurance and benefit information to support timely access to care and compliant billing within a Federally Qualified Health Center (FQHC). This role ensures eligibility verification, benefit coverage confirmation, prior authorization support, and coordination with clinical, front desk, and billing teams.

The specialist plays a critical role in revenue cycle integrity, patient access, and financial transparency while adhering to HRSA, CMS, Medicaid, Medicare, and payer regulations.

Education

High School Diploma or GED required. Associate’s degree in Healthcare Administration, Health Information Management, Business, or a related field preferred. Experience: Minimum of 1–3 years of experience in insurance verification, patient access, billing, or revenue cycle operations in a healthcare setting preferred. Licenses, Certification and/or Registration: No license required.

Professional certifications such as Certified Revenue Cycle Representative (CRCR) , Certified Healthcare Access Associate (CHAA) , or Certified Professional Biller (CPB) are preferred but not require.