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Overview

Join our dynamic team as a Benefits Investigation Specialist and be a crucial part of ensuring access to essential medications! We seek a compassionate individual to engage with Medical Insurance Payers and Pharmacy Benefit Managers, playing a vital role in identifying and documenting coverage options for retail and specialty medications.

Why work with us?

+ Immerse yourself in an excellent company culture with fun events and volunteer opportunities.

+ Enjoy competitive benefits, including medical, dental, vision, and more.

+ Please take advantage of our 401k package with a dollar-for-dollar match-up.

+ Generous PTO and paid holiday days are offered.

+ Embrace opportunities for professional and personal growth in our team-oriented atmosphere.

Responsibilities

What you will do:

+ Connect with Payers and Pharmacy Benefit Managers via outbound calls to verify patient insurance coverage and uncover available Medical and Pharmacy benefits.

+ Communicate case details to relevant internal or external parties, fostering effective collaboration.

+ Identify potential mechanisms for quick access to therapy by recognizing any payer coverage restrictions.

+ Showcase your ability to contribute effectively, whether working independently or in small workgroups.

+ Meet production and time completion goals with a focus on maintaining high-quality customer service standards in accordance with federal and state regulations.

+ Accurately document payer Prior Authorization and Appeals protocols, ensuring meticulous attention to detail.

+ Participate in special projects and embrace additional duties as required, contributing to a dynamic work environment.

+ Maintain a comprehensive repository of payer or brand-specific coverage information.

+ Engage in training and process improvement initiatives to enhance your professional growth.

Qualifications

What we need from you:

+ A high school diploma or equivalent is required; a Bachelor's degree is preferred.

+ Minimum of 2 years of experience in customer service, insurance, benefits, marketing, sales, or a related area is required, or a Bachelor's degree with one year of relevant experience.

+ Preferred experience in a healthcare environment focusing on third-party benefits verification.

+ Understanding of commercial insurance concepts, including coverage policies, major medical benefits, and knowledge of government and patient assistance programs.

+ Highly proficient in computer skills, including Microsoft tools, working from dual monitors, etc.

+ Strong email correspondence and personal documentation skills.

+ Fundamental analytic and problem-solving skills with excellent time management.

+ Demonstrated professional customer service experience with high attention to detail.

+ Be a critical thinker who is adaptable and results-driven.

Submit a Referral (https://careers-connectiverx.icims.com/jobs/1787/ben-investigation-spec-hub-svcs/job?mode=apply&apply=yes&in\_iframe=1&hashed=-1834382591)

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LocationUS-PA-Pittsburgh

ID2024-1787

Category Customer Service

Position Type Full Time

Remote No