Job Description

Insurance Processor - Commercial - Durable Medical Equipment

Job Summary

We are seeking a full-time, detail-oriented and organized Commercial Insurance, Durable Medical Equipment Processor to join our team. The ideal candidate will play a crucial role in verifying and processing commercial insurance claims related to durable medical equipment, primarily breast pumps and accessories. This position requires a strong understanding of major insurance companies verification processes. The successful applicant will be responsible for ensuring that all orders are submitted timely, accurately and efficiently, while adhering to durable medical equipment guidelines and HIPAA regulations.

Roles, Responsibilities & Expectations

Process commercial insurance claims for durable medical equipment, ensuring accuracy and compliance with industry as well as The Breastfeeding Shop standards. Verify insurance coverage and eligibility for customers. Knowledge of billing codes to accurately document patient orders and Company procedures. Obtains all necessary paperwork including scripts and authorizations. Communicates with customers through email or text as necessary. Investigates problem orders through resolutions. Collaborate and communicate effectively with insurance companies, healthcare providers, and customers to gather necessary information for claim processing. Stay updated on changes in insurance policies, coding practices, and regulations affecting DME claims processing. Process a minimum of 30 orders per day. Maintains a professional demeanor that supports the vision and mission of The Breastfeeding Shop. Other duties as assigned.

Measured Goals and Expectations:

As outlined in Insurance Order Processor primary role job description.

Qualifications:

3-5 yrs. experience independently verifying commercial medical insurance/coverage with all major insurance carriers. 3 plus years of billing and coding experience. High School Diploma or equivalent (G.E.D.) and 3-5 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. Proven organizational skills. Adaptable to changing requests and requirements. Experience using e-mail system for ongoing communication. Ring Central experience helpful. Salesforce experience a plus. Knowledge of computer database software and internet software beneficial.
The Breastfeeding Shop is for mothers who need help, guidance, with their pumps and accessories to help them with nursing their babies. 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.

Job Type: Full-time

Pay: $18.00 - $22.00 per hour

Expected hours: 40 per week

Benefits:

Health insurance Paid time off
Work Location: In person