Benefit Verification Specialist

OneOncology•Costa Mesa, CA

2d•Onsite

About The Position

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.

Requirements

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

Nice To Haves

Experience in oncology or specialty healthcare setting
Familiarity with prior authorization and financial counseling workflows
Knowledge of payer portals and eligibility verification tools

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