Job Title:

Benefit Investigation Specialist Location:

Pittsburgh, Pennsylvania (On-Site)

Job Summary:

We are seeking a detail-oriented Benefit Investigation Specialist to support patient access by verifying coverage options and documenting benefit information accurately. We are looking for a professional who can communicate effectively with payers and pharmacy benefit managers while delivering strong customer service and supporting timely access to therapy.

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, required; 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, reimbursements, third-party terms, and medical terminology preferred. High school diploma or equivalent required; bachelor's degree preferred. Ability to write routine reports and correspondence, work efficiently in Microsoft Office and Excel, take notes during telephone conversations, manage email correspondence, and apply strong analytic, problem-solving, time management, attention to detail, critical thinking, adaptability, and results-driven skills.

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. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from SSi People and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here: SSi People Privacy Policy