Claims Processing Specialist - Tarentum, PA

Job Location:

Blackburn's Corporate - Tarentum, PA 15084

Job Category:
Insurance Blackburn's Physicians Pharmacy, Inc. | Tarentum, PA

Full-Time | Monday-Friday | Daylight Schedule

Help Patients Access the Care They Need

At Blackburn's Physicians Pharmacy, Inc., we believe access to healthcare starts long before a patient receives their equipment. Every authorization secured, every claim processed, and every reimbursement resolved helps ensure patients receive the medical equipment and services they depend on.

We're looking for a detail-oriented, organized, and motivated Claims Processing Specialist to join our growing Claims Department in Tarentum. If you thrive in a fast-paced healthcare environment, enjoy problem-solving, and take pride in accuracy, this is an opportunity to build a rewarding career while making a meaningful impact on patient care.

• Review, process, and monitor medical insurance claims for accuracy, completeness, and compliance with payer guidelines.
• Verify insurance benefits, authorization requirements, and documentation needed for claim submission.
• Manage authorizations, reauthorizations, and prescription renewals to support uninterrupted patient care.
• Monitor outstanding claims, investigate denials, and perform timely follow-up with insurance carriers and providers.
• Communicate with insurance representatives to resolve claim issues, missing documentation, and reimbursement questions.
• Maintain accurate account notes, claim documentation, and audit-ready records within company systems.
• Utilize work queues and reporting tools to prioritize workloads and meet filing deadlines.
• Collaborate with billing, customer service, clinical teams, and referral sources to resolve claims efficiently.
• Identify recurring reimbursement issues and recommend process improvements to reduce denials and improve operational efficiency.

• Strong attention to detail with exceptional organizational and time management skills.
• Excellent analytical, problem-solving, and critical-thinking abilities.
• Strong verbal and written communication skills.
• Ability to manage multiple priorities while meeting deadlines in a fast-paced environment.
• Proficiency with computers, data entry, and Microsoft Office applications.
• Collaborative mindset with the ability to work independently and across multiple departments.
• Previous experience in healthcare claims processing, medical billing, insurance verification, or prior authorizations preferred.
• Knowledge of Medicare, Medicaid, commercial insurance, or the DME/HME industry is highly preferred.

• Monday-Friday daytime schedule with evenings and weekends off.
• Competitive pay and comprehensive benefits package.
• P aid time off and paid holidays.
• 401(k) with profit sharing.
• Hands-on training and ongoing professional development opportunities.
• Supportive leadership and a collaborative team environment.
• Career growth opportunities within a growing healthcare organization.
• Join a respected, family-owned healthcare company serving our communities for nearly 90 years.

Behind every successfully processed claim is a patient receiving the care and equipment they need. As a Claims Processing Specialist, your work helps remove barriers to care, supports timely reimbursement, and ensures patients receive the essential medical equipment that improves their quality of life.

Qualifications

• Previous experience in healthcare billing, claims processing, DME/HME, or insurance coordination preferred
• Understanding of Medicare, Medicaid, and commercial insurance processes is a must
• Strong attention to detail and problem-solving skills
• Excellent communication and organizational abilities
• Ability to work independently and as part of a team
• Comfortable working in a high-volume, deadline-driven environment
• Basic proficiency with Microsoft Office and computer-based systems