Benefits Investigation Specialist - Hybrid/Buffalo, NY

About Brook Inc

Brook Health is a digital health company. Brook offers a set of products and services extending health-care-management beyond the walls of doctors’ offices and into people’s homes and their day-to-day lives. Brook provides people who are living with chronic conditions a highly personalized high-touch support via a smartphone app offering AI tools, data collection through connected devices, and real-time access to health coaches to make smart, daily decisions and to build healthy habits to achieve their long-term health goals. Brook also offers a CDC-approved preventative program for people who are at high risk for diabetes. For primary care providers, Brook offers SaaS tools for continuous remote monitoring, providing insights into their patient’s health needs, enabling a new model of care, and early preventative interventions with our own care delivery team resulting in better health outcomes.

Brook offers a dynamic work experience with team members in multiple time zones. We have a fast-paced, user-centric, high-expectation, constantly-improving-ourselves type of culture. Our goal is to change the approach to pre-condition and chronic condition care management, to use technology to support health-care providers in improving patients’ health outcomes.

Job Summary:

We are seeking a Benefits Investigation Specialist to complete timely benefits investigation as assigned by the Benefits Investigation Manager for Remote Patient Monitoring (RPM), Principle Care Management (PCM), Advanced Primary Care Management (ACPM), and Chronic Care Management (CCM) CPT codes for current and eligible patients.

Key Responsibilities

Conducting Benefits Investigation (BI):

• Review the daily/weekly assignments from the Benefits Investigation Manager of eligible patients who require BI across multiple clinics and/or health systems.
• Review the state/regional guidelines for any updated payor information
• Conduct investigations for the assigned patients to meet daily/weekly goals.
• Document the patient's copay information into the Brook system.
• Contact insurance companies by phone to verify patient eligibility and benefits for medical services related to RPM, CCM, PCM, and APCM.

Throughput Monitoring & Optimization:

• Adhere to quality control measures to ensure correct benefit interpretation and data entry
• Document the number of BI completed each day and the time it took to complete them

Reporting & Communication:

• Report daily weekly progress to direct supervisor
• Report any system issues to supervisor immediately
• Collaborate with clinical and administrative staff to communicate benefit findings and address any discrepancies or authorization needs.

Perform assigned duties that support the following:

• Average turnaround time per benefits investigation
• Weekly throughput volume of completed investigations
• Percentage of patients with verified benefits within target time frame
• Number of escalations or errors related to benefit interpretation
• Weekly report delivery compliance

Qualifications

• 2+ years of experience in healthcare benefits verification, revenue cycle, or insurance operations
• Strong understanding of healthcare payers, healthcare terminology, eligibility checks, and patient financial responsibility
• Experience with RPM, DME, or chronic care billing preferred
• Proficient in using eligibility tools such as ClaimRev, Availity, or equivalent
• Excellent organizational and time management skills with the ability to prioritize and complete a high volume of benefit investigations on a regular basis
• Proficient in Excel, Google Sheets, and operational reporting
• Strong written and verbal communication skills

Why Brook?

• High-Impact Role: Own a core growth channel in a sector of healthtech experiencing rapid growth.
• Mission-Driven: Join a company that’s improving patient outcomes and transforming the way healthcare is delivered.
• Fast-Growing Environment: Thrive in a dynamic, scale-up atmosphere where you’ll have the autonomy to create meaningful change and implement new ideas from day one.
• Cutting-Edge Tech: Work with innovative tools and have the freedom to introduce new solutions, including AI-driven approaches.
• Collaborative Culture: Partner with passionate teams in Marketing, Product, and Clinic Ops to drive measurable results.

Working at Brook

• Fast-paced environment – Brook operates in two of the fastest changing industries in America – Healthcare and Technology. We move quickly to design tools and protocols based on customer and industry feedback. Thriving in an environment of change and continuous improvement is a core competency for all members of our team.
• Dynamic roles - We are a small and tight-knit team enthusiastically tackling difficult problems in an entrenched industry. All team members are expected to contribute to company protocols, provide product feedback and to generally think critically about our processes and care model.
• High expectations - We have big goals for the future. We expect dedication and positive collaboration from all our team to achieve them.

This position is not eligible for relocation or visa sponsorship. Candidates must live within a commuting distance from the office. This is a hybrid role, onsite in the office required weekly along with remote work.

Brook Inc is an equal opportunity employer. We are committed to building an inclusive and diverse workforce. Brook does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, marital status, age, non-disqualifying physical or mental disability, national origin or ethnic origin, military service status, citizenship or any other protected characteristic covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.