Job Title: Benefit Investigation Specialist
Location: Pittsburgh, Pennsylvania (On-Site)
Job Summary: We are recruiting for a Benefit Investigation Specialist opportunity with a company seeking a detail-oriented professional to support insurance and benefits verification activities. Our team is looking for someone who can help ensure accurate coverage research, clear documentation, and timely communication to support service quality and compliance.
Responsibilities:
- Make outbound calls to payers and pharmacy benefit managers to verify patient insurance coverage and identify available medical and pharmacy benefits.
- Communicate case details to appropriate internal or external parties once benefit verification is complete.
- Identify payer coverage restrictions and potential mechanisms for quickly accessing therapy.
- Document payer prior authorization and appeals protocols accurately while supporting training, process improvement, and special projects as needed.
Required:
- Minimum of 2 years of experience in customer service, insurance, benefits, marketing, sales, or a related area, or a bachelor’s degree with 1 year of relevant experience.
- Health care environment experience with third-party benefits verification preferred.
- Understanding of commercial insurance concepts, including coverage policies, major medical benefits, government and patient assistance programs, reimbursements, third-party terms, and medical terminology preferred.
- High school diploma or equivalent required; bachelor’s degree preferred.
- Strong professional customer service experience, excellent verbal communication skills, and the ability to work efficiently in Microsoft Office, including Excel.
- Ability to write routine reports and correspondence, manage email correspondence, maintain research documentation, and demonstrate strong analytic, problem-solving, time management, attention to detail, critical thinking, adaptability, and results-driven skills.
About SSI People: With over 26 years of industry experience, SSi People has built its reputation and expertise on putting people first. Everything we do works toward delivering exceptional experience for our consultants, our clients, and our internal team. Through a genuine commitment to people in everything we do. We have developed refined processes and a stellar internal team to deliver talent quickly. More importantly, we focus on building long-term relationships, not transactions. Putting people first is just what we do well.
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