Job Title: Benefit Investigation Specialist
Location: Pittsburgh, Pennsylvania (On-Site)
Job Summary: We are working with this company to present an opportunity for a detail-oriented professional who will help support accurate insurance and benefits verification for patients accessing therapy. This position plays an important part in communicating coverage information, documenting payer requirements, and supporting timely access to care.
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, maintain coverage information, and support training and process improvement initiatives.
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, third-party terms, and medical terminology.
- Strong verbal and written communication skills, including routine reports and correspondence, email correspondence, research documentation, and the use of Microsoft Office and Excel.
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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