Job Title: Benefit Investigation Specialist
Location: Pittsburgh, Pennsylvania (On-Site)
Job Summary: We are recruiting for a Benefit Investigation Specialist opportunity with this company, supporting a high-impact team focused on insurance and pharmacy benefit verification. Our team is seeking a detail-oriented professional who can help ensure accurate coverage information, timely documentation, and strong service delivery across internal and external interactions.
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 the appropriate internal or external parties once benefit verification is complete.
- Document payer prior authorization and appeals protocols accurately and maintain repository information for payer- or brand-specific coverage details.
- Support production and time-completion goals, participate in training and process improvement initiatives, and assist with special projects and additional duties as required.
Required:
- Minimum of 2 years of experience in customer service, insurance, benefits, marketing, sales, or a related area, or a bachelor’s degree plus 1 year of relevant experience.
- Experience in a health care environment 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.
- Ability to write routine reports and correspondence using computer applications, work efficiently in Microsoft Office, create spreadsheets in Excel, take notes during telephone conversations, manage email correspondence, and maintain personal documentation of research.
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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