Benefit Investigation Specialist

We are seeking a Benefits Investigation Specialist to verify patient insurance coverage and pharmacy benefits by contacting insurance payers and Pharmacy Benefit Managers (PBMs). Qualifications 2+ years of experience in customer service, insurance, benefits, healthcare, or a related field, or a Bachelor's degree with 1+ year of relevant experience.

Job Title: Benefits Investigation Specialist
Location: Pittsburgh, PA 15275
Duration: 2-Month Contract
Schedule: Monday–Friday | 9:00 AM – 5:30 PM

Position Summary
We are seeking a Benefits Investigation Specialist to verify patient insurance coverage and pharmacy benefits by contacting insurance payers and Pharmacy Benefit Managers (PBMs). The ideal candidate will ensure accurate documentation, identify coverage requirements, and provide excellent customer service while meeting productivity goals.
Key Responsibilities

• Verify medical and pharmacy insurance benefits.
• Contact insurance payers and PBMs to confirm coverage.
• Document benefit verification, prior authorizations, and appeals.
• Communicate coverage details to internal teams.
• Meet quality, productivity, and compliance standards.

Qualifications

• 2+ years of experience in customer service, insurance, benefits, healthcare, or a related field, or a Bachelor's degree with 1+ year of relevant experience.
• Healthcare or benefits verification experience preferred.
• Knowledge of insurance, medical terminology, and Microsoft Office.
• Strong communication, organization, and problem-solving skills.

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