Talent.com
Benefit Investigation Specialist

Benefit Investigation Specialist

ConnectiveRxPittsburgh, PA, United States
30+ days ago
Job type
  • Full-time
Job description

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 :

  • 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
  • Skills

  • Minimum of 2 years' experience in customer service, insurance, benefits, marketing, sales, or related area, required, or Bachelor's degree and 1 year of relevant experience
  • o Health care environment with third party benefits verification experience preferred.

  • Understanding of commercial insurance concepts including coverage policies, major medical benefits, knowledge of government and patient assistance program, knowledge of and understanding of how to communicate information on health insurance, reimbursements, third party terms and medical terminology is preferred
  • Ability to write routine reports and correspondence using computer applications. Excellent verbal skills and knowledge of medical terms.
  • Ability to work efficiently in Microsoft Office, including the creation of spreadsheets in Excel and the ability to take notes via computer keyboard during telephone conversations.
  • Skill in managing email correspondence and personal documentation of research.
  • Focus on fundamental analytic and problem-solving skills.
  • Excellent time management skills
  • Strong professional customer services experience
  • High level of attention to detail
  • Be a critical thinker who is adaptable, and results driven.
  • 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 :

    Create a job alert for this search

    Benefit Specialist • Pittsburgh, PA, United States

    Related jobs
    • Promoted
    Insurance Claims Specialist

    Insurance Claims Specialist

    WVU MedicineUniontown, PA, US
    Full-time
    Job Opportunity at Uniontown Hospital.We're excited you're considering an opportunity with us! To apply to this position and be considered, please complete the application in full.This position is ...Show moreLast updated: 30+ days ago
    • Promoted
    Investigator

    Investigator

    Ethos Risk ServicesPittsburgh, PA, US
    Full-time
    Ethos Risk Services is continuing to expand our team of.Experienced Licensed Investigators.Ethos Risk is one of the largest and most respected fraud investigations businesses in the US.Join us in u...Show moreLast updated: 30+ days ago
    • Promoted
    Intelligence Support Specialist

    Intelligence Support Specialist

    Clearance JobsPittsburgh, PA, US
    Full-time
    Intelligence Support Specialist.The Intelligence Support Specialist provides the Army Future's Command (AFC) organizations at Fort Eustis, VA. Fort Leavenworth, KS; White Sands Missile Range, NM; P...Show moreLast updated: 30+ days ago
    • Promoted
    Crisis Intervention Specialist Relief internal only

    Crisis Intervention Specialist Relief internal only

    Riverside Community CarePittsburgh, PA, United States
    Full-time
    By joining Numotion, you will be a part of the nation’s leading provider of Complex Rehabilitation Technology.Numotion is helping thousands of people with individually configured, medically necessa...Show moreLast updated: 3 days ago
    • Promoted
    Risk Investigator - Pittsburgh, PA

    Risk Investigator - Pittsburgh, PA

    First National Bank of PennsylvaniaPittsburgh, PA, United States
    Full-time
    Make a difference - for us and for your future.Risk Investigation Representative 2.This position has a critical role in ensuring the integrity and security of the bank's operations.Responsibilities...Show moreLast updated: 3 days ago
    • Promoted
    Addiction Specialist

    Addiction Specialist

    Tadiso IncEast Pittsburgh, PA, United States
    Full-time
    Job Description : Addiction Specialist.Location : Pittsburgh, PA, 15233.We are seeking a highly skilled and compassionate Addiction Specialist to join our team in Pittsburgh, PA.The ideal candidate w...Show moreLast updated: 2 days ago
    • Promoted
    Risk Investigator - Pittsburgh, PA

    Risk Investigator - Pittsburgh, PA

    First National BankPittsburgh, PA, United States
    Full-time
    Primary Office Location : 626 Washington Place.Make a difference - for us and for your future.Risk Investigation Representative 2. This position has a critical role in ensuring the integrity and secur...Show moreLast updated: 3 days ago
    • Promoted
    Loss Prevention Project Specialist

    Loss Prevention Project Specialist

    Oxford SolutionsPittsburgh, PA, US
    Full-time
    Loss Prevention Project Specialist.Contract Hybrid (2 days onsite per week) Pittsburgh, PA.Oxford Solutions is seeking a Loss Prevention Project Specialist for a contract role with our retail cli...Show moreLast updated: 30+ days ago
    • Promoted
    Special Agent, $40,000 Recruitment Incentive

    Special Agent, $40,000 Recruitment Incentive

    The United States Secret ServicePittsburgh, PA, US
    Full-time
    Recruitment Incentive : Applicants may be eligible for a $40,000 recruitment incentive in accordance with regulatory requirements. Click apply for complete details on the recruitment incentive detail...Show moreLast updated: 1 day ago
    • Promoted
    Special Agent : Military / Law Enforcement Expertise

    Special Agent : Military / Law Enforcement Expertise

    Federal Bureau of InvestigationPittsburgh, PA, United States
    Full-time
    The position advertised has been exempted from the federal civilian hiring freeze.Use your military background to become an FBI special agent!. The transition from law enforcement to special agent i...Show moreLast updated: 30+ days ago
    • Promoted
    Commercial Health Insurance Enrollment Specialist

    Commercial Health Insurance Enrollment Specialist

    Novus GroupPittsburgh, PA, US
    Full-time
    Commercial Health Insurance Enrollment Specialist.Pittsburgh, Pennsylvania 15219.Secure your future with a direct-hire position as an employee of the company – this is.As a proud partner of t...Show moreLast updated: 30+ days ago
    • Promoted
    Line of Business Risk Specialist Sr

    Line of Business Risk Specialist Sr

    PNCPittsburgh, PA, US
    Full-time +1
    At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve.We are all united in delivering the best experience for our customers.We work together each day ...Show moreLast updated: 25 days ago
    Behavioral Specialist

    Behavioral Specialist

    Community Options, Inc.Pittsburgh, PA, US
    Full-time
    Full-Time Behavioral Specialist.The Behavioral Specialist uses best practices and technology within a community-based setting to teach people with developmental disabilities how to acquire the phys...Show moreLast updated: 30+ days ago
    • Promoted
    Security Support Specialist

    Security Support Specialist

    Clearance JobsPittsburgh, PA, US
    Full-time
    The Security Support Specialist provides the Army Future's Command (AFC) organizations at Fort Eustis, VA; Fort Leavenworth, KS. White Sands Missile Range, NM; Pittsburgh, PA; Fort Sill, OK; Detroi...Show moreLast updated: 30+ days ago
    • Promoted
    Intake Specialist

    Intake Specialist

    Chaffin Luhana LLPPittsburgh, PA, US
    Full-time
    To be considered for this role, please call 866-996-6549 and follow the step-by-step instructions outlined by our Co-Founder and Managing Partner. In addition, please complete your application here....Show moreLast updated: 30+ days ago
    Benefits Specialist

    Benefits Specialist

    Interview HuntersPittsburgh, PA, US
    Full-time
    Quick Apply
    We are looking for a representative to join our team.This person will operate as the lead on all critical business accounts. The focus of this vital role is to manage the relationship with the clien...Show moreLast updated: 30+ days ago
    • Promoted
    Claims Investigator - Experienced

    Claims Investigator - Experienced

    Command InvestigationsPittsburgh, PA, US
    Full-time
    Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE / COE, Auto, and Homeowners. SIU experience is highly desired, but not require...Show moreLast updated: 30+ days ago
    • Promoted
    United States Border Patrol Agent

    United States Border Patrol Agent

    U.S. Customs and Border ProtectionManor, Pennsylvania, US
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 1 day ago
    • Promoted
    Addiction Specialist

    Addiction Specialist

    Tadiso Inc.Pittsburgh, PA, US
    Full-time
    Job Description : Addiction Specialist.Location : Pittsburgh, PA, 15233.We are seeking a highly skilled and compassionate Addiction Specialist to join our team in Pittsburgh, PA.The ideal candidate w...Show moreLast updated: 30+ days ago
    • Promoted
    Utility Locating Damage Investigator - Pittsburgh, PA

    Utility Locating Damage Investigator - Pittsburgh, PA

    Stake Center LocatingPittsburgh, PA, US
    Full-time
    The Damage Investigator position will be responsible for performing the following duties : .Perform damage investigations and document findings. Handle daily LP ticket audits to ensure locate accuracy...Show moreLast updated: 30+ days ago