- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (St. Paul, MN)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a*RCM Representative Senior*to join our Third-Party Claims -HB&PB team. This full-time role will primarily work remotely ... Knowledge of applicable federal and state regulations **Title:** *RCM Representative Senior, Third-Party Claims -HB&PB* **Location:** *MN-Minneapolis-Downtown Campus*… more
- Ryder System (St. Paul, MN)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Medtronic (Minneapolis, MN)
- …connected, compassionate world. **A Day in the Life** The Principal Insurance and Claims Management role is a newly created expert and highly specialized position ... at all levels to gather information for insurance placement, facilitates claims resolution between internal and external stakeholders, provides transparency and… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Senior Investigator - Pharmacy** **Job Class: Human Services Program Representative 2** **Agency: Human Services Dept** + **Job ID** : 90721 + ... job held.**_** Three (3) years of experience reviewing and/or submitting pharmacy claims to the Minnesota Medical Assistance program. AND Experience must demonstrate… more
- Insight Global (Roseville, MN)
- Job Description Insight Global is looking for an Outside Sales Representative to join a dynamic commercial team. This individual will serve as the primary interface ... Daily tasks include managing electronic order entry, expediting orders, resolving claims , and ensuring accurate pricing. The position requires frequent travel,… more
- Highmark Health (St. Paul, MN)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Ryder System (St. Paul, MN)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Jack Link's (Minneapolis, MN)
- …product label information, including nutrition, ingredient declaration, allergens, claims and associated product communication. This position manages several ... Compliance + Be subject matter expert for product labeling regulations and claims requirements including nutrition, health and ingredient claims . + Proactively… more
- Highmark Health (St. Paul, MN)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- CVS Health (St. Paul, MN)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Otsuka America Pharmaceutical Inc. (St. Paul, MN)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …the continuum of care by leveraging member partnership, pre-service clinical utilization review , case and disease management processes, skill sets and tools. Care ... responsible for answering customer questions pertaining to product information, benefits, claims resolution and eligibility in a call center environment. This… more
- Prime Therapeutics (St. Paul, MN)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- Target (Woodbury, MN)
- …balance proactive protection and real-time mitigation of risks. Our team, including Claims , Insurance, Finance, and Safety allows for a well-rounded approach to ... site safety program. Follow structured routines around data analysis, trend review , Leader Standard Work, hazard assessments and leadership communication. Ensure all… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …synthesizes data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals. Their work goes beyond extraction; it ... as Network and Pharmacy, ensuring data is pulled using the most representative methods. They also support high-risk regulatory reporting, where precision and speed… more
- Medtronic (Fridley, MN)
- …Affairs **AI & RWE Innovation** + Identify and apply real-world datasets (EMR, claims , registries) and AI/ML tools to enhance clinical strategy + Collaborate with ... based on closed study insights and market feedback + Review and prioritize External Research Program (ERP) and Collaborative...within the Responsibilities section of this job description are representative of those that must be met by an… more
- Allied Universal (St. Paul, MN)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... and timely workload management to meet assignment time completion. + Review and verify credentials, including education, training, licensure, and certification, for… more
- RxBenefits (Minneapolis, MN)
- …team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting. The successful Pharmacy Pricing Senior Manager will ... across internal stakeholders to foster collaborative and efficient work products + Review for accuracy and finalize all current account pricing comparisons for… more