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Medicaid Software Jobs in Iowa (NOW HIRING)

Apolis

Claims Processing Executive

Iowa City, IA · On-site

$16.50 - $20.75/hr

Medicaid * Commercial Insurance * Claims Adjudication * Eligibility Verification * HIPAA Compliance * CMS Guidelines * EDI Transactions * Claims Management Software * MS Excel * Insurance Policy ...

Mom's Meals

Director, Healthcare Partnerships

Ankeny, IA · On-site +1

$136K - $160K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Oversee and implement Medicaid and Long-Term Care field sales systems to maximize territory ... Experience with CRM, Salesforce or similar organizational sales software * Willingness to travel up ...

Mom's Meals

Director, Healthcare Partnerships

Ankeny, IA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Oversee and implement Medicaid and Long-Term Care field sales systems to maximize territory ... Experience with CRM, Salesforce or similar organizational sales software * Willingness to travel up ...

Cass Health

Coding Specialist

Atlantic, IA · On-site

Monitor delinquent and deficient records to support compliance with Medicare, Medicaid, and ... Utilize electronic health records and coding software to ensure accurate and timely coding and ...

Cass Health

Coding Specialist

Atlantic, IA · On-site

Monitor delinquent and deficient records to support compliance with Medicare, Medicaid, and ... Utilize electronic health records and coding software to ensure accurate and timely coding and ...

Care Initiatives

Business Office Manager (BOM)

State Center, IA · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Oversee Medicare, Medicaid, private insurance billing, and other reimbursement processes to ensure ... Proficiency with computer systems, financial software, and Microsoft Office applications. * Strong ...

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Showing results 1-20

All JobsMedicaid Software JobsMedicaid Software Jobs in Iowa

Medicaid Software information

What is the difference between Medicaid Software vs Medicaid Claims Specialist?

AspectMedicaid SoftwareMedicaid Claims Specialist
Primary RoleSoftware tools used to manage Medicaid data, billing, and complianceProcessing and reviewing Medicaid claims for accuracy and reimbursement
Required SkillsTechnical skills, software proficiency, data managementKnowledge of Medicaid policies, claims processing, attention to detail
Work EnvironmentHealthcare IT companies, software vendors, healthcare providersHealthcare facilities, insurance companies, Medicaid agencies
CertificationsNone typically required, but IT certifications helpfulMedical billing certifications, Medicaid-specific training

Medicaid Software refers to the tools and systems used to manage Medicaid data and billing processes, while Medicaid Claims Specialists focus on processing and verifying Medicaid claims. Both roles are essential in the Medicaid industry but serve different functions—one in software management and the other in claims processing.

What are some common challenges faced by professionals working with Medicaid software systems?

Professionals working with Medicaid software often encounter challenges such as navigating frequently changing federal and state regulations, integrating new modules with legacy systems, and ensuring data security and privacy in compliance with HIPAA. Additionally, collaborating with diverse stakeholders—including healthcare providers, government agencies, and IT teams—requires strong communication and project management skills. Staying updated with evolving technology standards and maintaining system interoperability are also key aspects of the role.

What are the key skills and qualifications needed to thrive as a Medicaid software specialist, and why are they important?

To thrive as a Medicaid Software Specialist, you need a solid background in healthcare IT, knowledge of Medicaid regulations, and experience with software development or implementation, typically supported by a degree in computer science or health informatics. Familiarity with Medicaid Management Information Systems (MMIS), claims processing tools, and compliance software is essential. Strong analytical skills, attention to detail, and effective communication help bridge the gap between technical teams and healthcare administrators. These skills ensure efficient, compliant, and user-friendly Medicaid systems that support both organizational goals and regulatory requirements.

What is Medicaid software?

Medicaid software refers to specialized technology platforms and applications designed to support the administration, management, and delivery of Medicaid health programs. These software systems help state agencies, healthcare providers, and payers manage eligibility, claims processing, member enrollment, reporting, and compliance with federal and state regulations. Medicaid software plays a crucial role in improving efficiency, reducing errors, and ensuring that Medicaid beneficiaries receive appropriate coverage and services. It can include modules for case management, billing, analytics, and provider management. Modern Medicaid software often integrates with other health information systems to facilitate seamless data exchange.

What are popular job titles related to Medicaid Software jobs in Iowa?

For Medicaid Software jobs in Iowa, the most frequently searched job titles are:

What job categories do people searching Medicaid Software jobs in Iowa look for?

The top searched job categories for Medicaid Software jobs in Iowa are:

What cities in Iowa are hiring for Medicaid Software jobs?

Cities in Iowa with the most Medicaid Software job openings:

Medicaid Software jobs near you

Claims Processing Executive

Apolis

Iowa City, IA • On-site

$16.50 - $20.75/hr

Other

Posted 9 days ago

Job description

Job Title: Healthcare Claims Processing Executive (QNXT Claims)
Location: Remote ( Iowa Residents Only)
Tax Term: W2
Job Type: Contract
Duration: 3-6 Months
Job Description:
Join our team as a Claims Processing Executive in the healthcare sector where you will utilize your expertise in MS Excel to efficiently manage and process commercial claims. This remote position offers the flexibility of working from home during day shifts, allowing you to balance work and personal commitments effectively. Your contributions will directly impact the accuracy and efficiency of our claims processing, enhancing customer satisfaction and operational excellence.
Roles & Responsibilities:
  • Review, validate, and process healthcare claims submitted by providers in accordance with US insurance policies.
  • Work on the QNXT claims platform (Required).
  • Verify patient eligibility, coverage, benefits, and pre-authorization requirements under Medicare, Medicaid, and private insurance plans.
  • Approve, deny, or adjust claims based on payer guidelines and policy terms.
  • Maintain compliance with HIPAA regulations, CMS guidelines, and other US healthcare compliance standards.
  • Record claim activity, maintain audit trails, and prepare reports for management.
  • Utilize MS Excel for claims tracking, reporting, and analysis.
  • Required Skills:
  • QNXT Claims Processing (Required)
  • Healthcare Claims Processing
  • Commercial Claims
  • Medicare
  • Medicaid
  • Commercial Insurance
  • Claims Adjudication
  • Eligibility Verification
  • HIPAA Compliance
  • CMS Guidelines
  • EDI Transactions
  • Claims Management Software
  • MS Excel
  • Insurance Policy Interpretation
  • Analytical & Problem-Solving Skills
  • Strong Communication Skills
  • Detail-Oriented
  • Qualifications:
  • High school diploma or equivalent (Required).
  • 2-4 years of experience in US healthcare claims processing.
  • Strong knowledge of US healthcare insurance systems, including Medicare, Medicaid, and commercial payers.
  • Familiarity with claims management software and EDI transactions.
  • Excellent analytical, organizational, and communication skills.
  • Ability to interpret insurance policies and payer guidelines.
  • Detail-oriented with strong problem-solving abilities.
  • Must be a resident of Iowa.
  • Must be comfortable with a 3-6 month contract.

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