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Electronic Claims Specialist
3 weeks ago
We are seeking an Electronic Claims Specialist to join our team at Allianz Popular SL. As an Electronic Claims Specialist, you will be responsible for managing the transition of electronic claims processes and ensuring compliance with local laws.
Key Responsibilities
- Manage the transition of electronic claims processes, ensuring compliance with local laws and overseeing the integration and optimization of regulatory systems within the scope of Medical Provider Management.
- Possess comprehensive knowledge of local regulations related to e-platforms and their implications, with responsibility for managing the E-transformation, pricing, and cost impact within the scope of Medical Provider Management (MPM).
- Lead and manage regulatory projects related to medical provider management and electronic post office systems.
- Review, analyze, and ensure the alignment of electronic claims processes with business objectives and compliance standards.
Requirements
- Bachelor's degree in Healthcare Management, Business Administration, Project Management or a related field.
- Certification in Coding (CPC, CCS, CIC, COC, CCA, HCPCS).
- 3-5 years proven experience in project management, particularly in electronic claims platform and regulatory projects.
- In-depth knowledge of electronic claims processes and medical coding systems.
- Deep understanding of the intricacies and requirements of local regulatory e-platforms.
