- Sedgwick (Des Moines, IA)
- …Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Claims Specialist , Professional Liability (A&E, D&O) **ESSENTIAL ... by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and… more
- Molina Healthcare (Des Moines, IA)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- CVS Health (Des Moines, IA)
- …+ Distributes work assignment daily to junior staff. + Trains and mentors claim benefit specialists. + Makes outbound calls to obtain required information ... handle customer service inquiries and problems. **Additional Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication… more
- CVS Health (Des Moines, IA)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- Prime Therapeutics (Des Moines, IA)
- …+ MISCELLANEOUS DUTIES: + Provide backup support to team members (SIU Coordinator and Senior SIU Specialist ) in the performance of job duties as assigned. + ... drives every decision we make. **Job Posting Title** SIU Specialist - Remote in the California market **Job Description**...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… more
- Zurich NA (Des Moines, IA)
- Sr. TPA Specialist , Complex Claims 125068 Zurich Insurance is currently looking for a Sr TPA Specialist . This position will oversee complex Liability ... Specialist analyzes highly complex coverage situations, evaluates high exposure claims , seeks/grants authority, assigns/explains reserves to senior management… more
- Delta Dental of Iowa (Johnston, IA)
- Compliance and Privacy Specialist Johnston, IA (http://maps.google.com/maps?q=9000+Northpark+Drive+Johnston+IA+USA+50131) Apply Job Type Full-time Description Come ... to our customers. Our team enjoys competitive pay and benefits , an awesome "One Team" approach, and a company...and navigate sensitive matters related to organization, employee and senior leadership situations. + Perform other duties as assigned.… more
- Highmark Health (Des Moines, IA)
- …months in either Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America's Health InsurancePlans (AHIP) **Language ... structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The...type of industry, characteristics of employee groups, or past claim experience to determine what benefits can… more
- Zurich NA (Des Moines, IA)
- …125444 Zurich North America is currently looking to fill an opening for a Senior Vice President for our Large Contract Surety Underwriting Team. Seeking a candidate ... approach to business relationships and oversight on strategic underwriting practices. The Senior VP is responsible for: + Developing processes and reviewing policies… more