Benefit Investigation Specialist

Job Title : Benefit Investigation Specialist

Location : Pittsburgh, PA 15275

Duration : 2 – 5 Months (High Possibility with Extension or conversion for full time employee)

Job Summary :

Responsible for contacting medical insurance payers and pharmacy benefit managers to verify patient coverage for retail and specialty medications while maintaining high customer service standards.

Key Responsibilities :

• Make outbound calls to payers / PBMs to verify medical and pharmacy benefits
• Identify coverage restrictions and access pathways
• Communicate case details to internal / external teams
• Document prior authorization and appeal requirements
• Maintain payer / brand-specific coverage information
• Support training and process improvement initiatives