Job Description

Key Responsibilities

• Order Intake & Eligibility Verification
• Review patient orders and check insurance eligibility through payer portals.
• Contact patients for missing information or clarification when eligibility is not met.
• Insurance Verification & Documentation
• Verify insurance coverage, deductibles, and co-insurance.
• Contact physicians for missing documents or qualifying diagnoses.
• Confirm doctor credentials and prescription compliance.
• Scan and upload documents into Brightree.
• Order Processing
• Create and manage sales orders in Brightree.
• Enter and maintain accurate patient and order data.
• Ensure all required documents are attached for billing and compliance.
• Fulfillment Coordination
• Collect deductibles and coinsurance prior to fulfillment.
• Forward complete orders to the fulfillment team for processing.
• Confirmation & Billing
• Confirm order completion and document submission.
• Submit orders to insurance for reimbursement.
• Track and address claim denials, ensuring timely resolution.
• Customer Interaction
• Serve as a point of contact for customers, caregivers, and referral sources.
• Recommend DME products based on patient needs and diagnosis.
• Maintain professionalism and empathy throughout customer interactions.
• Compliance
• Ensure adherence to industry standards including HIPAA, The Joint Commission, OSHA, DOT, and FDA guidelines.
• Other Duties
• Perform additional responsibilities as assigned by management.

Required Qualifications

• High school diploma or GED required; some college or healthcare certification is a plus.
• Minimum 3 years of customer service or order management experience; healthcare or DME background preferred.
• Minimum of 2 years with Brightree experience (required)
• Proficiency in Microsoft Office (preferred)
• Strong communication, critical thinking, and time management skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Familiarity with insurance billing, order fulfillment, and medical terminology is a plus.
• Computer proficiency in MS Word, Excel, and Outlook preferred
• Database data entry experience preferred.
• Strong knowledge and use of the English language, both written and verbal
• Work history of excellent attendance and punctuality
• High comfort level working with culturally diverse team members and clients.
• Proficient mathematical skills, including addition, subtraction, multiplication, and division.

Performance Metrics

• Weekly order volume (processed and confirmed)
• Order denial rate
• Timeliness of order confirmation (<14 days old)
• Call handling metrics (talk time, abandonment rate, etc.)

Preferred Qualifications:

• Startup / rapid growth experience
• Life sciences, pharmaceutical, or medical device experience.
• Knowledge of medical terminology preferred.

Language Skills

Must be able to communicate effectively in English.  Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of an organization.