- Highmark Health (Des Moines, IA)
- …:** **JOB SUMMARY** This job pricies quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, ... etc. The incumbent develops and uses discretion of Underwriting authority, within the policies of HMIG, and ensure appropriate levels of profitability and growth over time. Identifying when to decline quotes that do not fit into the overall HMIG strategy and… more
- Molina Healthcare (Des Moines, IA)
- …of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, Universal Claims, Stop Loss , Surgery, Anesthesia, high dollar complicated claims, COB and DRG/RCC ... to Molina Medicare's maximum STAR ratings.. **Job Qualifications** **Required Education** Associate 's Degree or 4 years of Medicare grievance and appeals experience.… more