Benefit Investigation Specialist - Late Shift

About the role

We are seeking a detail-oriented professional to support insurance coverage verification and benefits research for retail and specialty medications. Our team is partnering with this company to find someone who can deliver accurate documentation, strong customer service, and effective coordination across internal and external parties.

Responsibilities

• Make outbound calls to payers and pharmacy benefit managers to verify patient coverage and identify available medical and pharmacy benefits.
• Document case details accurately and communicate findings to the appropriate internal or external parties once benefit verification is complete.
• Identify payer coverage restrictions and document prior authorization and appeals protocols with accuracy and consistency.
• Support production goals, time completion targets, special projects, training initiatives, and process improvement efforts as needed.

Requirements

• Minimum of 2 years’ experience in customer service, insurance, benefits, marketing, sales, or a related area, or a Bachelor’s degree with 1 year of relevant experience.
• Health care environment experience with third-party benefits verification preferred.
• Understanding of commercial insurance concepts, coverage policies, major medical benefits, government and patient assistance programs, reimbursements, third-party terms, and medical terminology preferred.
• High school diploma or equivalent required; Bachelor’s degree preferred.
• Ability to work efficiently while taking notes during telephone conversations and maintaining accurate documentation.

Skills

• Strong verbal communication skills.
• Writing ability for routine reports and correspondence.
• Microsoft Office proficiency including Excel.
• Email management.
• Research skills.
• Attention to detail.
• Time management skills.