Benefit Investigation Specialist

Magnit Direct Sourcing on behalf of ConnectiveRx is currently hiring for an Benefit Investigation Specialist rolefor a temporary assignment in Pittsburgh, Pennsylvania .

Duties

Responsible for direct contact with Medical Insurance Payers and Pharmacy Benefit Managers in order to identify and document available coverage options for retail and specialty medications. Maintains high quality customer service standards in compliance with federal and state regulations and guidelines.

What you will do :

• Makes outbound calls to Payers and Pharmacy Benefit Manager in order to verify patient insurance coverage and identify available Medical and Pharmacy benefits
• Communicates case details to appropriate internal or external parties once benefit verification is complete
• Identify any payer coverage restrictions and potential mechanisms for quickly accessing therapy
• Ability to effectively contribute alone or in small work groups
• Effectively meets production and time completion goals
• Accurately document payer Prior Authorization and Appeals protocols
• Participate in special projects and perform additional duties as required
• Maintain repository of payer or brand specific coverage information
• Participate in training and process improvement initiatives

What you will do :

Skills

o Health care environment with third party benefits verification experience preferred.

Education

High school diploma or equivalent, required. Bachelor's degree preferred

Magnit is an equal opportunity employer, and all applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status.

QUALIFICATION / LICENSURE

Work Authorization : US Citizen

Preferred years of experience : 1 years

Travel required : No travel required

Shift timings :