AI Summary

This role handles insurance eligibility verification for US healthcare patients, validating benefits, coverage details, and payer requirements. It supports operations and collaborates with product/engineering to improve automated verification workflows.

About this role

About 100ms

100ms is building AI agents that automate complex patient access workflows in U.S. healthcare — starting with benefits verification, prior authorization, and referral intake in specialty pharmacy.

We help care teams reduce delays and administrative burden so that patients can start treatment faster. Our automation platform combines deep healthcare knowledge with LLM-based agents and robust ops infrastructure.

You’ll be joining a specialized team at 100ms focused on healthcare automation using AI.

About the Role

We’re hiring a Benefits Verification Specialist** with 1–4 years of experience in US health insurance eligibility and benefits verification. You’ll be part of our operations team, helping verify insurance benefits for patients receiving speciality care in the U.S.

This is a full-time, in-office role based in Bangalore, with partial overlap with US hours.

Key Responsibilities

Perform insurance verification and eligibility checks for commercial and government payers (e.g., Medicare, Medicare Advantage, Medicaid, Managed Medicaid, VA, DoD).

Validate coverage details including deductibles, co-pay/coinsurance, network status, referrals, prior authorization requirements, and J-code/CPT-code specific benefits.

Contact payer representatives via phone or payer portals as needed.

Push back on payer based on previous experience.

Accurately document findings in internal systems.

Collaborate with internal teams to resolve missing or mismatched data.

Collaborate with technology teams to improve data/systems.

Ensure timely completion of verifications with high accuracy and within defined SLAs.

Requirements

2+ years** of experience in **US healthcare insurance verification **

Familiarity with payer portals (e.g., Availity, Navinet, Aetna, UHC)

Understanding of insurance types (commercial, Medicare, Medicaid, HMO/PPO, etc.)

Working knowledge of CPT codes, HCPCS, and payer-specific benefits rules

Strong attention to detail and ability to document accurately

Proficient in written and spoken English

Good to Have

Experience in specialty pharmacy, oncology, infusion therapy, or behavioral health

Background working with RCM platforms, EMRs, or AI-based automation tools

Why 100ms.ai

Be part of a team solving critical problems in healthcare automation

High-ownership role in a startup culture with mentorship and fast learning

Work closely with product and engineering teams building cutting-edge AI agents

Contribute to improving access to care for patients across the U.S.

Website

https://www.100ms.ai/

Skills

AI-based Automation Tools (optional)CPT CodesData Collaboration With Tech TeamsDocumentation AccuracyEnglish (written And Spoken)HCPCSInsurance Types (commercial, Medicare, Medicaid, HMO/PPO)Payer Portals (Availity, Navinet, Aetna, UHC)Payer-specific Benefits RulesSpecialty Pharmacy Knowledge (nice To Have)US Health Insurance VerificationUtilizing EMRs/RCM Platforms

Benefit Verification Specialist - AI Agents (Healthcare)