Healthcare Customer Service Specialist

Blackburn's Physicians Pharmacy, Inc. | Tarentum, PA

Full-Time | Monday-Friday | Daylight Schedule

Join a healthcare team where your attention to detail directly impacts patient care.

Blackburn's Physicians Pharmacy, Inc. is seeking a dependable, customer-focused Customer Service Representative with experience in insurance verification, healthcare benefits, medical billing, or durable medical equipment
.

This is more than a traditional customer service position. Our CSRs help patients navigate the process of receiving essential medical equipment and supplies while working behind the scenes to confirm insurance coverage, gather required information, and ensure orders can move forward accurately and efficiently.

If you enjoy helping people, solving insurance-related issues, and working in a fast-paced healthcare environment, we want to hear from you.

• Verify patient insurance eligibility, benefits, coverage, and payer requirements.
• Review Medicare, Medicaid, commercial insurance, and managed-care coverage information.
• Determine whether required documentation, referrals, prescriptions, or prior authorizations are in place before an order moves forward.
• Communicate with insurance companies, patients, physician offices, referral sources, and internal departments to obtain missing or updated information.
• Accurately enter and maintain patient demographics, insurance information, documentation, and order details.
• Explain insurance coverage requirements and next steps to patients in a professional and easy-to-understand manner.
• Identify insurance or documentation issues that could delay an order and work proactively to resolve them.
• Answer inbound customer calls and provide timely, courteous assistance regarding orders, products, coverage, and service needs.
• Coordinate with billing, clinical, warehouse, service, and other departments to help ensure a smooth patient experience.
• Follow established procedures and payer guidelines while maintaining confidentiality and HIPAA compliance.
• Provide the level of service and follow-through patients should expect when relying on Blackburn's Physicians Pharmacy, Inc. for their healthcare needs.

• Previous insurance verification experience is strongly preferred.
• Experience working with Medicare, Medicaid, commercial insurance, medical billing, prior authorizations, or healthcare benefits is highly desirable.
• Previous experience in durable medical equipment, healthcare, pharmacy, physician practice, hospital, insurance, or another medical environment is preferred.
• Strong customer service and telephone communication skills.
• Ability to interpret insurance information and explain requirements clearly to patients.
• Strong attention to detail and commitment to accurate documentation.
• Comfortable working with multiple computer systems while speaking with patients and insurance representatives.
• Ability to manage multiple priorities and follow up on outstanding items without losing track of details.
• Strong problem-solving skills and willingness to take ownership of an issue through resolution.
• Dependable, professional, and able to work effectively as part of a team.
• High school diploma or equivalent required.

We are especially interested in candidates who have hands-on experience with:

• Insurance eligibility and benefit verification
• Medicare and Medicaid
• Commercial insurance plans
• Medical terminology
• DME/HME billing or order processing
• Reviewing prescriptions and supporting documentation
  
  Working with physician offices and referral sources
• Resolving insurance denials, coverage discrepancies, or missing documentation

At Blackburn's Physicians Pharmacy, Inc., our Customer Service team plays an important…