- Sedgwick (Dubuque, IA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Data Scientist ( REMOTE ) Data Scientist ( Remote ) **PRIMARY PURPOSE OF THE ROLE:** To develop ... modeling challenges, findings, and outcomes to stakeholders **QUALIFICATIONS** + Insurance claims knowledge preferred + Minimum one year of predictive modeling, data… more
- Prime Therapeutics (Des Moines, IA)
- …drives every decision we make. **Job Posting Title** Pricing Analyst Senior - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Sharecare (Des Moines, IA)
- …The role of the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to members and their families ... eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status,… more
- Cognizant (Des Moines, IA)
- **Member Appeals & Grievances Specialist** ( remote ) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We ... of 2 years of Appeals and Grievance experience Minimum of 2 years of medical claims processing experience (Must be with a healthcare plan, not on behalf of provider… more
- Molina Healthcare (Cedar Rapids, IA)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... implementation and conversion of new and existing health plans. + Executes retroactive claims reports + Runs fee schedule & MRDT update processes + Writes complex… more
- Molina Healthcare (Davenport, IA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes. **JOB QUALIFICATIONS** **Required… more
- Molina Healthcare (Davenport, IA)
- …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
- Molina Healthcare (Iowa City, IA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... the development, implementation and maintenance of provider data in the claims payment system. * Supports critical business strategies by providing systematic… more
- Prime Therapeutics (Des Moines, IA)
- …drives every decision we make. **Job Posting Title** Sr Solution Strategist - Remote **Job Description** **Calling all Solution Strategists! We are looking for a ... platforms and products + Experience using queries, thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly… more
- Prime Therapeutics (Des Moines, IA)
- …drives every decision we make. **Job Posting Title** Reporting Principal - Remote **Job Description** The Finance Reporting Principal is responsible for supporting ... leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in the implementation of… more