- Highmark Health (Des Moines, IA)
- …terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim...5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience… more
- Cognizant (Des Moines, IA)
- … 3 +years Medicare/Medicaid regulatory healthcare experience + Knowledge of claim adjudication processes and Facets platform experience preferred + Experience ... IT organization and lead changes to such specifications (with senior business analyst oversight through peer reviews); Develop an informed knowledge of the business… more
- Highmark Health (Des Moines, IA)
- …Must Be Able to Read and Comprehend Spanish Medical Terminology The Quality analyst is responsible for compiling and analyzing data relevant to the handling of ... all types of complex adjusted claims ; conducting reviews of all organizational or functional activities...remediation and Regulatory and legal guidelines. In addition, the Analyst will identify potential areas of processing vulnerability through… more
- Prime Therapeutics (Des Moines, IA)
- …passion and drives every decision we make. **Job Posting Title** Sr. Market Pricing Analyst - REMOTE **Job Description** The Senior Market Pricing Analyst serves ... new and revised financial pricing strategies based on analysis of pharmacy claims data, average wholesale drug prices (AWP), health plan margin target guidelines… more
- Robert Half Technology (West Des Moines, IA)
- …mathematical concepts and calculations to support analyses and reporting. Requirements * Minimum of 3 years of experience as a Business Analyst or in a related ... Description We are looking for an experienced Business Analyst to join our team in West Des...tools, including requirements gathering and documentation. * Experience with claim administration, annuities, and related business processes. * Excellent… more
- Highmark Health (Des Moines, IA)
- …School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's Degree **EXPERIENCE** **Required** + 3 - 5 years of experience in a Business Analyst or ... role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 1 -..., billing, customer service, etc.) **Preferred** + 1 - 3 years in the Health Insurance Industry **LICENSES OR… more
- Humana (Des Moines, IA)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Prime Therapeutics (Des Moines, IA)
- …every decision we make. **Job Posting Title** Associate Health Informatics Analyst **Job Description** Design, document, develop and roll out financial, clinical ... **Responsibilities** + Performs exploratory data analysis and data mining of healthcare claims and authorizations data. + Designs, documents, develops and rolls out… more
- Evolent (Des Moines, IA)
- …SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data + Working on a strategic analytics team using data to identify ... problems that align with key strategic objectives **Qualifications - Required and Preferred:** + 3 or more years of **advanced** experience using SQL Must be able to… more
- Highmark Health (Des Moines, IA)
- …+ 5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project ... Pittsburgh will be required to work in the office 3 days per week, as determined by business needs....a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative,… more
- Molina Healthcare (Des Moines, IA)
- …staff for mentoring, coaching, and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory ... Math, Computer Science, Information Systems, or related field **Required Experience** + 3 years management or team leadership experience + 10 years' work experience… more
- Air National Guard Units (Des Moines, IA)
- …in work such as computer operator or assistant, computer sales representative, program analyst , or other positions that required the use or adaptation of computer ... degree may be substituted. At the GS-11 level, a Ph.D. or equivalent, or 3 years of progressively higher level graduate education leading to such a degree.… more