- 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
- 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 (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