Benefit Investigation Specialist

PSKW LLC dba ConnectiveRx LLC

Pittsburgh, PAFull-time$15.26–22/hrPosted 6mo agoSeen in employer's feed 3 days ago

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At a glance

Compensation

$15.26–22/hr

Location

Pittsburgh, PA

Schedule

Full-time

Work Authorization

Not specified

Olive lists jobs from US employers, including remote roles you can work from the United States.

Job overview

PSKW LLC dba ConnectiveRx LLC is hiring a Benefit Investigation Specialist. The Benefits Investigation Specialist plays a crucial role in ensuring patient access to essential medications. This compassionate individual engages with Medical Insurance Payers and Pharmacy Benefit Managers to identify and document coverage options for retail and specialty medications, helping to untangle the complex prescription process.

Key focus areas include Connect with Payers and Pharmacy Benefit Managers via outbound calls to verify patient insurance coverage and uncover available Medical and Pharmacy benefits., Communicate case details to relevant internal or external parties, fostering effective collaboration., and Identify potential mechanisms for quick access to therapy by recognizing any payer coverage restrictions..

Successful candidates bring High School Diploma and 2+ Years Customer Service Experience. Important skills include Microsoft Tools, Email Correspondence, Personal Documentation, Fundamental Analytic Skills, Problem-Solving Skills, and Time Management. Preferred (not required): Working Independently, Working In Small Workgroups, High-Quality Customer Service Standards, and Payer Prior Authorization Protocols.

Skills & qualifications

RequiredNice to have

Skills

Microsoft ToolsEmail CorrespondencePersonal DocumentationFundamental Analytic SkillsProblem-Solving SkillsTime ManagementProfessional Customer ServiceAttention to DetailProblem SolvingAdaptabilityResults-DrivenWorking IndependentlyWorking in Small WorkgroupsHigh-Quality Customer Service StandardsPayer Prior Authorization ProtocolsPayer Appeals ProtocolsTrainingProcess Improvement InitiativesCommercial Insurance ConceptsCoverage PoliciesMajor Medical BenefitsGovernment ProgramsPatient Assistance Programs

Qualifications

High School Diploma or Equivalent2 Years Customer Service Experience2 Years Insurance Experience2 Years Benefits Experience2 Years Marketing Experience2 Years Sales Experience1 Year Relevant Experience With Bachelor's DegreeWorking From Dual MonitorsHealthcare Environment Experience Focusing on Third-Party Benefits Verification

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Match

Paid Time Off

Full job description

Overview

Being on medication is tough enough. We want to make getting it the easy part. Getting prescriptions to patients has become increasingly complex. When things get messy along the prescription journey, pharmaceutical manufacturers rely on us to untangle the process and create a clear path—allowing patients to build trusting relationships with their medication brands.

We’re not only committed to taking the pain out of the prescription process, but we’re also devoted to bringing the brightest minds together under one roof. We bring together diverse voices—engineers, pharmacists, customer service veterans, developers, program strategists and more—all with one vision. Each perspective and experience makes ConnectiveRx better than the sum of its parts.

Join our dynamic team as a Benefits Investigation Specialist and be a crucial part of ensuring access to essential medications! We seek a compassionate individual to engage with Medical Insurance Payers and Pharmacy Benefit Managers, playing a vital role in identifying and documenting coverage options for retail and specialty medications.

Responsibilities

Connect with Payers and Pharmacy Benefit Managers via outbound calls to verify patient insurance coverage and uncover available Medical and Pharmacy benefits.
Communicate case details to relevant internal or external parties, fostering effective collaboration.
Identify potential mechanisms for quick access to therapy by recognizing any payer coverage restrictions.
Showcase your ability to contribute effectively, whether working independently or in small workgroups.
Meet production and time completion goals with a focus on maintaining high-quality customer service standards in accordance with federal and state regulations.
Accurately document payer Prior Authorization and Appeals protocols, ensuring meticulous attention to detail.
Participate in special projects and embrace additional duties as required, contributing to a dynamic work environment.
Maintain a comprehensive repository of payer or brand-specific coverage information.
Engage in training and process improvement initiatives to enhance your professional growth.

Qualifications

A high school diploma or equivalent is required; a Bachelor's degree is preferred.
Minimum of 2 years of experience in customer service, insurance, benefits, marketing, sales, or a related area is required, or a Bachelor's degree with one year of relevant experience.
Preferred experience in a healthcare environment focusing on third-party benefits verification.
Understanding of commercial insurance concepts, including coverage policies, major medical benefits, and knowledge of government and patient assistance programs.
Highly proficient in computer skills, including Microsoft tools, working from dual monitors, etc.
Strong email correspondence and personal documentation skills.
Fundamental analytic and problem-solving skills with excellent time management.
Demonstrated professional customer service experience with high attention to detail.
Be a critical thinker who is adaptable and results-driven.

Compensation & Benefits: Compensation for this role varies based on factors such as location, relevant skills, experience, and capabilities.

Employees at ConnectiveRx can enroll in comprehensive benefit plans, including medical, dental, vision, life, and disability insurance. The company retains the right to update or modify health, welfare, and other fringe benefit policies. Employees may also participate in the company's 401(k) plan.

Time-Off & Holidays: ConnectiveRx provides paid time off (PTO) to non-exempt employees for vacations and personal leave. For sick leave, eligible non-exempt employees receive Sick Time Off (STO) in accordance with company policy. PTO and STO are prorated during the first year of service. Employees also receive eight standard company holidays and three floating holidays annually, with floating holidays prorated in the first year.

The company is committed to maintaining competitive benefits and reserves the right to adjust employee offerings, including PTO, STO, and holiday policies, in compliance with applicable laws and regulations.

Posted Salary Range

USD $15.26 - USD $22.00 /Hr.

Submit a Referral (https://careers-connectiverx.icims.com/jobs/3576/benefit-investigation-specialist/job?mode=apply&apply=yes&in\_iframe=1&hashed=-1834382591)

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LocationUS-PA-Pittsburgh

ID2026-3576

Category Customer Service

Position Type Full Time

Remote No