US Healthcare | Benefits Verification Specialist

Job Summary

Handle complex Patient Assistance Program (PAP) cases by evaluating applications, conducting benefits verification, determining eligibility, and supporting patients and healthcare providers throughout the enrollment process.

Key Responsibilities

• Handle escalated and complex PAP inquiries from patients and healthcare providers.
• Review and evaluate patient assistance applications against program eligibility guidelines.
• Conduct benefit investigations and verify insurance coverage details.
• Process approvals, denials, and application escalations accurately and efficiently.
• Communicate eligibility decisions, application status, renewal requirements, and prescription updates.
• Generate and send approval or denial communications to patients and healthcare providers.
• Perform outbound calls to complete application requirements and resolve missing information.
• Manage cases from intake to resolution while maintaining accuracy and compliance.
• Escalate unresolved issues to SMEs or client stakeholders as needed.

Qualifications

• Bachelor's degree required; Allied Health, Healthcare, Business, or related courses preferred.
• At least 2-3 years of experience in US Healthcare, Patient Access, Patient Assistance Programs (PAP), Benefits Verification, Reimbursement Support, or Healthcare BPO Operations.
• Minimum of 1 year experience handling escalated or advanced healthcare support functions.
• Strong verbal and written English communication skills.
• Excellent decision-making, problem-solving, and customer service skills.
• Ability to explain complex eligibility decisions and handle sensitive patient situations professionally.
• Willing to work onsite in Taguig City.
• Willing to work on a Graveyard Shift schedule with fixed weekends off.

Preferred Skills

• Experience in Benefits Verification, Prior Authorization, Insurance Verification, Reimbursement Support, Patient Access, or Specialty Pharmacy Programs.
• Knowledge of Patient Assistance Programs (PAP) and healthcare eligibility requirements.
• Experience using Salesforce Health Cloud, CRM platforms, Five9, or similar healthcare systems.
• Strong case management, document review, and healthcare claims processing experience.
• Background in Healthcare, Health Insurance, Specialty Pharmacy, Patient Support Services, or Provider Services is highly preferred.

Why Join Us:

At Cognizant, we don't just offer jobs—we build careers that thrive in the digital era.

• Growth That Matters – Clear career paths, continuous learning, and opportunities to move into leadership or specialized roles. You're not just filling a seat—you're building a future.
• Support That Empowers – A collaborative culture where your voice is heard, your ideas matter, and your well-being is prioritized through strong benefits and work-life balance.
• Impact That Inspires – Work on global accounts that shape industries, influence millions of users, and give you a sense of purpose beyond the paycheck.

Your future starts here—grow, thrive, and make an impact with Cognizant.