- 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
- Sedgwick (Eden Prairie, MN)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr. **Senior Disability Representative - Make a Meaningful ... do you._** **We're not just a global leader in claims management; we're a team driven by empathy, expertise,...your moment.** **WHAT YOU'LL DO** **As a Senior Disability Representative , you'll be the go-to guide for individuals navigating… more
- Sedgwick (Eden Prairie, MN)
- … system. + Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims . + Evaluates and arranges appropriate ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr **Our teams connect! We collaborate onsite and have a hybrid… 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
- Humana (St. Paul, MN)
- …where your expertise truly makes an impact! As a Grievances & Appeals Representative , you'll be a go-to problem solver, turning complex challenges into clear ... that information is accurate. + Forwards appeals to CMS entity for further review . + Investigates and resolves member and practitioner issues. + Works within broad… 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
- 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
- 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
- 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