• Clinical Appeals

    Robert Half Accountemps (Eden Prairie, MN)
    Description Clinical Appeals Representative (Contract - Fully Remote) We're seeking a detail-oriented Clinical Appeals Representative to join our ... health insurance operations by managing documentation, coordinating with providers, and ensuring appeals and grievances are processed accurately and on time. This is… more
    Robert Half Accountemps (11/15/25)
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  • Clinical Appeals

    Robert Half Office Team (Minneapolis, MN)
    …Are you looking for a rewarding remote role in healthcare administration? This Clinical Appeals Representative position offers the opportunity to make ... a meaningful impact while working from the comfort of your home. As a Clinical Appeals Representative , you will play a key role in managing the intake and… more
    Robert Half Office Team (12/05/25)
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  • Customer Service Representative - Bilingual…

    CVS Health (St. Paul, MN)
    …to incoming correspondence and internal referrals. + Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. ... Fluency in English and Spanish is required.** **Position Summary** Customer Service Representative is the face of Aetna and impacts members' service experience by… more
    CVS Health (12/11/25)
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  • Care Advocacy Case Manager RN - Bilingual Spanish

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets and ... and eligibility in a call center environment. * Conducts comprehensive clinical assessments; gathers, analyzes, synthesizes and prioritizes member needs and… more
    Blue Cross and Blue Shield of Minnesota (10/21/25)
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  • Healthcare Analyst Senior

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …domains, including utilization management, prior authorization, claims, denials, and appeals . Their work goes beyond extraction; it involves interpreting nuanced ... 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
    Blue Cross and Blue Shield of Minnesota (10/08/25)
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