Analysis Skills, Communication Skills, Customer Support/Service, Detail Oriented, Documentation, Health Insurance, Healthcare, Medical Terminology, Microsoft Excel, Microsoft Office, Microsoft Outlook, Problem Solving Skills, Process Improvement, Reimbursement, Time Management
Job Title: Benefit Investigation Specialist
Job Location: Pittsburgh, PA 15275
Job Duration: 2 + Month (High Possibility with Extension or conversion for Full time)
Schedule: Mon - Fri 8am-4:30pm Hours Per Week:40.00
Responsibilities:
- Contact Medical Insurance Payers and Pharmacy Benefit Managers to verify patient insurance coverage and available medical/pharmacy benefits.
- Document benefit verification details, prior authorization, and appeals information accurately.
- Identify coverage restrictions and support access-to-therapy solutions.
- Communicate case updates with internal teams and external partners.
- Maintain payer and coverage information records.
- Meet productivity, quality, and turnaround time goals.
- Participate in training, process improvement initiatives, and special projects.
Required Skills & Qualifications
- Minimum 2 years of experience in customer service, insurance, healthcare, benefits verification, or related field.
OR Bachelor’s degree with 1+ year of relevant experience. - Experience with healthcare insurance verification or third-party benefits preferred.
- Knowledge of medical terminology, insurance coverage, reimbursement, prior authorization, and appeals processes preferred.
- Strong communication, customer service, and problem-solving skills.
- Proficiency in Microsoft Office, especially Excel and Outlook.
- Strong attention to detail, time management, and documentation skills.
- Ability to work independently and in team environments.
- Adaptable, analytical, and results-driven mindset.
C
Careers Integrated Resources Inc