Claims Processing Specialist - Tarentum, PA

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.

What You'll Do

• 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.

What We're Looking For

• 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.

Why Join Blackburn's?

• Monday-Friday daytime schedule with evenings and weekends off.
• Competitive pay and comprehensive benefits package.
• Paid 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.

Make an Impact Every Day

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.

If you're looking for a career where your attention to detail, problem-solving skills, and dedication make a real difference, apply today and become part of the Blackburn's team.

• 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