What are the responsibilities and job description for the Benefit Investigation Specialist position at SSi People?

Job Title: Benefit Investigation Specialist

Location: Pittsburgh, Pennsylvania (On-Site)

Job Summary: We are seeking a Benefit Investigation Specialist to support accurate benefits verification and payer research for retail and specialty medications. Our team is looking for a detail-focused professional who can help ensure timely documentation, clear communication, and strong customer service in a regulated healthcare environment.

Responsibilities

Make outbound calls to payers and Pharmacy Benefit Managers to verify patient insurance coverage and identify available medical and pharmacy benefits.
Document case details accurately and communicate verification outcomes to appropriate internal or external parties.
Identify payer coverage restrictions and potential pathways for timely therapy access.
Maintain accurate records of payer prior authorization and appeals protocols while supporting training and process improvement efforts.

Required

Minimum of 2 years of experience in customer service, insurance, benefits, marketing, sales, or a related area, or a Bachelor’s degree with 1 year of relevant experience.
Experience in a health care environment 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.
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 via computer keyboard during telephone conversations, and manage email correspondence and research documentation.
Strong verbal communication, analytic and problem-solving skills, time management, attention to detail, critical thinking, adaptability, and a results-driven mindset.

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

Apply for this job

Receive alerts for other Benefit Investigation Specialist job openings

Benefit Investigation Specialist

What are the responsibilities and job description for the Benefit Investigation Specialist position at SSi People?

What is the career path for a Benefit Investigation Specialist?

Sign up to receive alerts about other jobs with skills like those required for the Benefit Investigation Specialist.

Job openings at SSi People

Not the job you're looking for? Here are some other Benefit Investigation Specialist jobs in the Pittsburgh, PA area that may be a better fit.

We don't have any other Benefit Investigation Specialist jobs in the Pittsburgh, PA area right now.

AI Assistant is available now!