Benefit Investigation Specialist

Job Title: Benefit Investigation Specialist
Job Location: Pittsburg, PA 15275
Job Duration: 4-5 Month (High Possibility with Extension or Conversion for Full Time)

Schedule: DAYS - 8HR; Monday – Friday
 
Job Description:
We’re seeking a Benefit Verification Specialist responsible for contacting medical insurance payers and pharmacy benefit managers to verify patient coverage for retail and specialty medications. This role plays a key part in ensuring timely access to therapy while maintaining high customer service standards and compliance.
 
Key Responsibilities:

• Make outbound calls to payers/PBMs to verify medical and pharmacy benefits.
• Document prior authorization and appeals protocols.
• Identify coverage restrictions and access solutions.
• Communicate benefit details internally and externally.
• Meet quality, productivity, and documentation standards.
• Support process improvement and special projects.

 
Qualifications:

• 2+ years of experience in insurance, customer service, healthcare, or benefits (Or 1 year with a bachelor’s degree).
• Experience with third-party benefits verification preferred.
• Strong understanding of insurance terms, reimbursement, and medical terminology
• Proficient in Microsoft Office (Excel, Outlook, Word).
• Excellent communication, time management, and problem-solving skills.
• Detail-oriented and results-driven.