26 Results for

Claims Processor Jobs in Des Moines, IA

Jobs

New!

West Des Moines, IA4 days ago

What You'll Do: As a Claims Representative, you will have a strong focus on customer service, as you will be responsible for promptly and efficiently answering questions from our customers, as well as following up on outstanding issues. Work Authorization/Sponsorship: At this time, we are not considering candidates that need any type of immigration sponsorship now or in the future, such as additional or permanent work authorization.

New!

West Des Moines, IA5 days ago

Add to that an onsite wellness facility with fitness classes and programs, a daycare center, a cafeteria, and for many positions, even consideration for a hybrid work arrangement. What You'll Do: As a Claim Service Representative - MedPay/PIP, you will review, investigate, and evaluate medical and Personal Injury Protection (PIP) claims payments.

West Des Moines, IA18 days ago

Full-time

Knowledge of Microsoft Office products (Outlook, Word, Excel, PowerPoint).Excellent organizational, interpersonal, written, and verbal communication skills. What You'll Do: As a Claims Representative, you will have a strong focus on customer service, as you will be responsible for promptly and efficiently answering questions from our customers, as well as following up on outstanding issues.

Des Moines, IA30+ days ago

Remote

Full-time

Proficient with claim and coding tools and resources, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and/or the Claims Subcontractor as needed.

Des Moines, IA30+ days ago

Remote

Full-time

Under limited supervision, manages and performs claims department activities related to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding.

Des Moines, IA30+ days ago

Remote

Full-time

Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.

Des Moines, IA30+ days ago

Remote

Full-time

The Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.

Des Moines, Iowa30+ days ago

Remote

The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives.

Des Moines, IA30+ days ago

Remote

$223,800–$313,100 Per Year

The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. The Medical Director’s work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management.

Des Moines, IA30+ days ago

Remote

Full-time

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.

Des Moines, Iowa7 days ago

Remote

$20.34–$36.35 Per Hour

Posting Window: We will accept applications for 3 full days following the Original Posting Date, after which the posting may remain open or be removed based upon applications received. In this fast-paced environment, every single day offers new challenges and the ability to use your excellent analytical, multitasking, attention to detail, prioritization, and interpersonal skills to assist with our clients’ life insurance claims.

Urbandale, Iowa20 days ago

The SIU Manager will be responsible for overseeing a team of investigators and support specialists, managing complex and high-exposure investigations, and assisting with investigative tools to support the enterprise anti-fraud efforts. Completion of one or more of the following designations: Fraud Claims Law Specialist (FCLS), Certified Insurance Fraud Investigator (CIFI), Certified Fraud Examiner (CFE), Chartered Property Casualty Underwriter (CPCU), Associate in Claims (AIC).

Des Moines, IA30+ days ago

Full-time

This position is perfect for candidates in the following industries in a "hunter," sales role: Tech & Software (SaaS, PaaS, IaaS), Logistics & Transportation, Business & Professional Services, Manufacturing & Industrial/Construction, Medical and Pharmaceutical, Finance & Insurance, Hospitality & Sales Services. Educate Homeowners:Explain and build value in our products and services, our brand, discuss the insurance claims process or retail pricing with financing, ensuring the customer understands their exterior home solution options.

Des Moines, IA25 days ago

Serving as the primary liaison between Sun Life DentaQuest and our client at Iowa Health and Human Services, the Program Integrity Manager is based near Des Moines, Iowa, works full time, and is responsible for ensuring transparency, accountability, and safeguarding the integrity of Medicaid programs through full access to claims, processing data, and investigative resources. The Program Integrity Manager leads and oversees a Medicaid Managed Care program integrity operation, providing strategic direction, leadership, and oversight of special investigations and contractor activities to prevent and address fraud, waste, and abuse while upholding compliance regulations.

Des Moines, IA30+ days ago

Remote

$117,600–$161,700 Per Year

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Works with the Test Lead to develop plans of action for testing new technology products, including identifying areas to be tested and designing targeted test strategies.

Des Moines, IA30+ days ago

Remote

$78,400–$107,800 Per Year

The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.

Des Moines, IA30+ days ago

Remote

$65,000–$88,600 Per Year

Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Des Moines, IA30+ days ago

Remote

Full-time

The Director ensures the delivery of exceptional service to providers and government stakeholders by directing cross-functional programs that enhance provider satisfaction, strengthen network engagement, and uphold contractual and regulatory compliance. Coaching / Training / Mentoring: Actively develops the skills and capabilities of direct reports and extended team members through constructive feedback, mentoring relationships, and structured development opportunities aligned with business outcomes.

Des Moines, IA30 days ago

Remote

Full-time

Technical Skills: Knowledge of technology impacts on business strategic direction enabling definition and integration of technical plans supporting the enterprise business functions; knowledge and expertise in project/program management methodologies and tools to include Agile; experience with product/solution/system lifecycles; expert knowledge in one or more of: system servers and data network; traditional telephony principals and support; Microsoft enterprise software, server principals and support; HP enterprise products and services: data communication and network architectures, design, and support; installation, maintenance and support of large scale application systems; healthcare industry experience, to include medical management and provider data/solutions: proficient with Microsoft Project, Project Server, Visio, and SharePoint Services. • 7+ years of related and progressive experience combining various elements of technical delivery or support, solutions implementation, process automation, project management, and team leadership .

Des Moines, IA30+ days ago

Communicate effectively with physicians and pharmacy network providers to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and timely manner. This role involves a high volume of daily contacts with members, physicians, and pharmacies to address medication-related issues, promote adherence, and ensure appropriate medication utilization.

Des Moines, IA30 days ago

Remote

Full-time

Technical Skills: The ability to solve problems independently while working in a fast paced, energetic environment; strong communication skills, (oral and writing skills); a proven ability as a facilitator/instructor; self-motivated, able to work in a team and independently. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Des Moines, Iowa29 days ago

You'll be in a patient-facing role, working closely with both patients and providers while supporting a structured and organized operation. You won't be managing the business—but you will play a key role in making sure everything runs smoothly day to day.

Urbandale, Iowa20 days ago

Berkley Corporation has grown from a small investment management firm into one of the largest commercial lines property and casualty insurers in the United States. Responsibilities: The SIU Investigator is responsible for conducting timely investigations into claims where indicators of potential fraud, misrepresentation, or suspicious activity exist.

Des Moines, IA30+ days ago

$165,000–$180,000 Per Year

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

West Des Moines, Iowa20 days ago

Assist multi-line exclusive agents in determining the most effective way to protect the futures and livelihoods of FBFS client/members and prospective client/members by providing phone and electronic mail sales support regarding questions about property and casualty insurance products and services. What You'll Do: The Senior P&C Sales Consultant is responsible for developing and executing P&C sales initiatives, providing delivery of sales support to the agency force and proactively driving initiatives that result in new account growth and improved client retention.

Des Moines, IA14 days ago

Remote

$80,000–$95,000 Per Year
Full-time

Please note: If this position is posted as either fully remote and/or hybrid, in accordance with company policy, individuals residing within a 50-mile radius of a branch location may be required to work onsite in a hybrid capacity as there may be occasions when on-site presence is necessary to meet specific business needs. This role requires a deep understanding of insurance industry workflows and the ability to translate business needs into actionable product strategies that deliver measurable impact.

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Claims Processor Jobs in Des Moines, IA

Jobs

Claims RepresentativeFarm Bureau Financial Services

Claims Service Representative- Claims Medical TeamFarm Bureau Financial Services

Claims RepresentativeFBL Financial Group, Inc and its Affiliated Companies

Claims ReviewerTriWest Healthcare Alliance

Claims Recoup & Collect AnlystTriWest Healthcare Alliance

Sr Claims ReviewerTriWest Healthcare Alliance

Supervisor, Claims AdminTriWest Healthcare Alliance

Senior Lost Time Workers Compensation Claims Adjuster - NE, IN, IL, IA, KS, MOGallagher

Medical Director - Claims ManagementHumana

Claims Escalation RepTriWest Healthcare Alliance

Claim Analyst 2Principal Financial Group

SIU ManagerBerkley

Outside Sales RepresentativeAmeriPro Roofing

Program Integrity Manager, DentaQuest (Iowa)Sun Life Financial

Medicaid State Technology LeadHumana

Manager, Fraud and WasteHumana

Encounter Data Management ProfessionalHumana

Director, Provider ExperienceTriWest Healthcare Alliance

IT Delivery LeadTriWest Healthcare Alliance

Pharmacy Coordinator SeniorHighmark Health

Provider Relations RepTriWest Healthcare Alliance

Staff PharmacistAlediumHR

SIU InvestigatorBerkley

Managing Director, , Actuarial ServicesEvolent

Sr. P&C Sales ConsultantFarm Bureau Financial Services

Product Owner (AI & Insurance Innovation)Insurance Office of America

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