Medical Claims Processor

4 weeks ago


Des Moines, Iowa, United States US01 AllCare Plus Pharmacy, Inc. Full time

Job Title: Patient Support Medical Claims Processing Representative

Job Summary:

We are seeking a highly skilled Patient Support Medical Claims Processing Representative to join our team at US01 AllCare Plus Pharmacy, Inc. The ideal candidate will have experience in claim processing, medical billing, and coding, with a strong understanding of Explanation of Benefits (EOB) and HIPPA regulations.

Key Responsibilities:

  • Receive and process medical claims from healthcare providers and patients
  • Ensure accurate and timely processing of claims, adhering to program-specific business rules
  • Interpret EOBs and CMS1500 forms to determine claim validity
  • Provide exceptional customer service via phone, email, or other communication channels
  • Collaborate with internal teams to resolve operational challenges and suggest recommendations for process improvements

Requirements:

  • High School Diploma or equivalent
  • Experience in claim processing, medical billing, and coding
  • Medical Billing and Coding Certification
  • Ability to interpret EOBs and HIPPA regulations
  • Customer service experience preferred
  • Pharmacy Technician experience preferred

What We Offer:

US01 AllCare Plus Pharmacy, Inc. is an Equal Opportunity Employer, committed to diversity and inclusion. We offer a competitive salary, benefits package, and opportunities for professional growth and development.


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