Insurance Processor-Commercial

The Breastfeeding Shop•Emmaus, PA

About The Position

Insurance Processor, Commercial - DME Breast Pumps and Accessories Summary: Processes insurance orders by verifying insurance coverage with customer’s insurance carrier. Maintains a professional demeanor that supports the vision and mission of The Breastfeeding Shop. Roles, Responsibilities & Expectations Primary Role: Processes all commercial orders as received/assigned within 24 hours. Verifies customers insurance coverage for eligibility. Obtains all necessary paperwork including scripts and authorizations. Communicates with patients regarding their order when necessary. Communicates with patients when their insurance does not cover items ordered. Assigned orders that are complete but waiting on a payment and/or RX to the follow up folders. Review follow up folders to see if required payment and/or RX was received and follow workflow procedures depending on such. Investigates problem orders through resolutions. Process a minimum of 30 commercial orders per day. Notifies Insurance Processing Manager of any issues or problems. Other duties may be assigned. Measured Goals and Expectations: As outlined in primary role of the Order Processor job description. Qualifications: 2-5 yrs. experience independently verifying medical insurance/coverage with all major insurance carriers. 2 plus years of billing and coding experience. High School Diploma or equivalent (G.E.D.) and 2-5 years’ insurance related experience. Excellent verbal and written communication skills. Strong inter-personal skills with the ability to effectively interact with co-workers and customers. Ability to multitask and prioritize assignments. Problem solving skills in standardized situations. Strong attention to detail with proven ability to work accurately and efficiently. Must be organized, flexible and adaptable to changing requests and requirements. High School Diploma or equivalent (G.E.D.) Experience using e-mail system for ongoing communication. Ring Central experience a plus. Knowledge of computer database software and internet software beneficial. The Breastfeeding Shop is for mothers who need proper help, guidance, and accessories to help them with nursing their babies, The Breastfeeding Shop brings the best of all. We are a family-owned business and because we understand the joys and challenges of being a new mom, we have brought together a range of supplies for all mothers who choose to breastfeed or those who need access to a breast pump. www.thebreastfeedingshop.com The Breastfeeding Shop is an equal-opportunity employer.

Requirements

2-5 yrs. experience independently verifying medical insurance/coverage with all major insurance carriers.
2 plus years of billing and coding experience.
High School Diploma or equivalent (G.E.D.) and 2-5 years’ insurance related experience.
Excellent verbal and written communication skills.
Strong inter-personal skills with the ability to effectively interact with co-workers and customers.
Ability to multitask and prioritize assignments.
Problem solving skills in standardized situations.
Strong attention to detail with proven ability to work accurately and efficiently.
Must be organized, flexible and adaptable to changing requests and requirements.
High School Diploma or equivalent (G.E.D.)
Experience using e-mail system for ongoing communication.
Knowledge of computer database software and internet software beneficial.

Nice To Haves

Ring Central experience a plus.

Responsibilities

Processes all commercial orders as received/assigned within 24 hours.
Verifies customers insurance coverage for eligibility.
Obtains all necessary paperwork including scripts and authorizations.
Communicates with patients regarding their order when necessary.
Communicates with patients when their insurance does not cover items ordered.
Assigned orders that are complete but waiting on a payment and/or RX to the follow up folders.
Review follow up folders to see if required payment and/or RX was received and follow workflow procedures depending on such.
Investigates problem orders through resolutions.
Process a minimum of 30 commercial orders per day.
Notifies Insurance Processing Manager of any issues or problems.
Other duties may be assigned.