What are the responsibilities and job description for the Benefit Investigation Specialist position at Careers Integrated Resources Inc?
Job Title: Benefit Investigation Specialist
Job Location: Pittsburgh, PA , 15275
Job Duration: 3 Months (Possibility of Extension)
Shift: Mon – Fri 08: 00 am - 04:30pm
Job Description:
Required Education
Work Experience
Job Location: Pittsburgh, PA , 15275
Job Duration: 3 Months (Possibility of Extension)
Shift: Mon – Fri 08: 00 am - 04:30pm
Job Description:
- 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
- Participate in training and process improvement initiatives
Required Education
- High school diploma or equivalent.
Work Experience
- Minimum of 1 years’ experience in customer service, insurance, benefits, marketing, sales, or related area, required, or Bachelor’s degree and 1 year of relevant experience
- 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
