Healthcare Claims Specialist - Des Moines - beBeeClaimProcessor

    beBeeClaimProcessor
    beBeeClaimProcessor Des Moines

    1 week ago

    Job title: Claims Process Executive

    Description

    Job Title:


    Claims Processing Professional



    Role Overview


    This position entails efficiently managing and processing commercial claims in the healthcare sector utilizing MS Excel expertise.


    • Review, validate, and process healthcare claims submitted by providers according to US insurance policies,
    • Verify patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans,
    • Approve, deny or adjust claims based on payer guidelines and policy terms,
      Maintain adherence to HIPAA regulations CMS guidelines other US Healthcare compliance standards Record claim activity maintain audit trails prepare reports management Required Skills & Qualifications High school diploma or equivalent Strong knowledge of us health care insurances systems medicare medicaid commercial payers 24 years experience us health care claims processing Familiarity with Claims Management software EDI transactions Excellent analytical organizational communication skills Ability interpret insurance policies Payer Guidelines Detail oriented strong problem-solving abilities Competencies Regulatory Knowledge Deep understanding Us Health Care Laws payer Requirements Accuracy & Detail Orientation Ensures correct efficient costumer satisfaction operational excellence Problem-Solving Resolves claim disputes denials effectively By performing these tasks you will contribute directly accuracy efficiency our clinics ensuring customer satisfaction operational excellence With excellent leadership qualities your contributions will be greatly valued team Your background providing accurate data managing resolve issues promptly great asset Our company looking highly skilled individuals bring unique perspective team We offer competitive salary benefits flexible work environment opportunities professional growth

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