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)

LocationUS-PA-Pittsburgh

ID2024-1787

Category Customer Service

Position Type Full Time

Remote No