retirement benefits specialist

State of South Carolina

<div><div><div><h2 class="jobSectionHeader"><b>Job Responsibilities</b></h2></div><br>
<p></p><div><br>
<br>
The SC Public Employee Benefit Authority (PEBA) is the administrator and co-trustee of retirement and insurance programs for over half a million active and retired public employees of the State of South Carolina and their dependents.<br>
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This position is responsible for processing retirement claims for members and beneficiaries of the South Carolina Retirement System, the Police Officers Retirement System, the State Optional Retirement Program, and the South Carolina National Guard Retirement System.<br>
<br>
<b>Job duties include:</b><br>
<ul><li>
Processing claims for benefits upon the death of members (retired, active, and inactive) and beneficiaries.</li><li>
Processing claims for service and disability retirement benefits.</li><li>
Finalizing benefit payments for service and disability retirees who are on payroll in estimated status.</li><li>
Processing refund claims so that members receive refund payments.</li></ul></div><p></p>
<div><h2 class="jobSectionHeader"><b>Minimum and Additional Requirements</b></h2></div>
<div><p>A bachelor's degree and at least one year of professional experience in retirement programs or a closely related area. An equivalent combination of education and related experience may be substituted for the required degree.<br>
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<i>Ability to read and comprehend retirement statutes and applicable written materials. Ability to explain retirement matters to members, employers, and beneficiaries. Ability to communicate effectively in oral and written form. Ability to perform mathematical calculations with a high degree of accuracy. Ability to prioritize and complete a large volume of work with close attention to detail.</i></p></div>
<div><h2 class="jobSectionHeader"><b>Additional Comments</b></h2></div>
<div><p>In addition to 13 paid holidays, this position is eligible for comprehensive insurance programs, retirement plans, and a generous paid leave program.</p></div></div></div>

Benefits Specialist - Retirement Claims

Amerita

<div>Our Company:
<div>
Amerita</div><div></div>
Overview:
<div><b>Amerita is hiring a Benefits Investigation Specialist for a remote role.</b></div><div>
Join our home infusion team This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow-up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. Apply today and become part of a team committed to making a difference!</div><div>
</div><div><b>
Schedule:</b></div><div><b>
Monday - Friday 9:30am - 6:30pm CST</b></div><div>
</div><div><b>
Benefits and perks for you!</b></div><div>
Medical, Dental, Vision insurance</div><div>
Health Savings &amp; Flexible Spending Accounts (up to $5,000 for childcare)</div><div>
Tuition discounts &amp; reimbursement</div><div>
401(k)</div><div>
Company Paid Time Off*</div><div>
Shift Differential</div><div>
DailyPay</div><div>
Pet Insurance</div><div>
Employee wellness and discount programs</div><div>
</div><ul><li><i>Benefits may vary by employment status</i></li></ul>
Responsibilities:
<ul><li>Verifies patient prescription benefits, including medical and pharmacy coverage, to ensure accurate billing and reimbursement</li><li>
Investigates authorization requirements for medications and any ancillary supplies, collaborating with healthcare providers and insurance companies as necessary</li><li>
Determines patient eligibility for copay card assistance programs based on program criteria and facilitate enrollment as appropriate</li><li>
Knowledgeable to perform all Benefit Investigation functions. Provides thorough, accurate and timely responses to requests</li></ul>
Qualifications:
<ul><li>High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy</li><li>
1+ years pharmacy experience</li><li>
Pharmacy or healthcare-related knowledge</li><li>
Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication</li><li>
Basic math and analytical skills</li><li>
Intermediate typing/keyboard skills</li></ul>
About our Line of Business: Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit www.ameritaiv.com. Follow us on Facebook, LinkedIn, and X. Additional Job Information:
<ul><li><b>Percentage of Travel: </b>0-25%</li></ul>
Salary Range: USD $21.00 - $26.00 / Year</div>

Benefits Investigation Specialist/ Remote

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p>
Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems.</p><ul><li>
Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise.
</li><li>Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process.</li><li>
Performs claim re-work calculations.</li><li>
Follow through completion of claim overpayments, underpayments, and any other irregularities.</li><li>
Process complex non-routine Provider Refunds and Returned Checks.</li><li>
Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks.
</li><li>Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals.</li><li>
Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures.</li><li>
Review and handle relevant correspondences assigned to the team that may result in adjustment to claims.</li><li>
May provide job shadowing to lesser experience staff.</li><li>
Utilize all resource materials to manage job responsibilities.</li></ul><p><b><br>
Required Qualifications</b></p><ul><li>
2+ years medical claim processing experience.</li><li>
Experience in a production environment.</li><li>
Demonstrated ability to handle multiple assignments competently, accurately, and efficiently.</li>
Effective communications, organizational, and interpersonal skills.<br>
<li>
</li></ul><p><br>
<b>Preferred Qualifications</b></p><ul><li>
DG system claims processing experience.</li><li>
Associate degree preferred.</li></ul><p><b><br>
Education</b></p><ul><li>
High School Diploma or GED.</li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$18.50 - $42.35<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
We anticipate the application window for this opening will close on: 06/19/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Senior Claims Benefit Specialist

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Benefits Specialist - Retirement Claims

Benefits Investigation Specialist/ Remote

Senior Claims Benefit Specialist

Senior Claims Benefit Specialist

Senior Claims Benefit Specialist

Senior Claims Benefit Specialist

Senior Claims Benefit Specialist