- Sanford Health (MN)
- …40.00 **Salary Range:** $15.00 - $22.00 **Job Summary** The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or ... to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical… more
- Wolters Kluwer (Minneapolis, MN)
- …in a resolution conference to be held with the law firm and client representative , when direct appeals mediation with the law firm does not successfully ... Moreover, the QA Analyst II, as part of our Appeals Team, will engage in written communications with the...Additional Responsibilities and Skills: + Conduct periodic audit and data analysis to support management in collecting and verifying… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … data across multiple domains, including utilization management, prior authorization, claims , denials, and appeals . Their work goes beyond extraction; it ... with internal teams such as Network and Pharmacy, ensuring data is pulled using the most representative ...degree. * Knowledge of managed care and health care claims preferred. * Experience with Databricks preferred. Compensation and… more
- Highmark Health (St. Paul, MN)
- …of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …responsible for answering customer questions pertaining to product information, benefits, claims resolution and eligibility in a call center environment. This ... Responsible for answering customer questions pertaining to product information, benefits, claims resolution and eligibility in a call center environment. * Conducts… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a*Prior Authorization Representative Senior*to join our**Financial Securing**team. This full-time role will primarily work ... * Follows up on any prior authorization denials; assists Utilization Management with appeals , as needed * Connects patients with financial counselors, as necessary *… more