Rx Claims Specialist: PBM Mastery (Hybrid, MN)
Saransh
Saransh Inc is seeking a skilled Rx Claims SME in Eden Prairie, Minnesota for a hybrid position. The ideal candidate will possess extensive knowledge of RxClaim Adjudication and PBM concepts. You will facilitate discussions with Product Owners and provide clarity on business requirements, utilizing your 10 years of industry experience. This role demands strong expertise in drug pricing and claims processing. #J-18808-Ljbffr Saransh
- ...Minnesota, is seeking a skilled professional with in-depth knowledge on RxClaim Adjudication and claims processing. The ideal candidate will have a strong understanding of PBM concepts, including drug pricing and copays, and be proficient in managing data validation....Suggested
$20.38 - $36.44 per hour
...discretion in handling confidential information in a fast-paced, highly matrixed environment. Work location: Eden Prairie, MN (on-site/hybrid expectations aligned to local office needs) This position follows a hybrid schedule with four in-office days per week....SuggestedRemote jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaShift work- Sedgwick Claims Management Services Ltd seeks a Sr Disability Representative in Eden Prairie, MN. This role requires providing comprehensive disability case management, analyzing... ...management. The position allows for a hybrid work environment, facilitating work-life balance...Suggested
$88k - $145k
...to the Senior Manager, Product. In this hybrid role, you will be expected to work a minimum... ..., MA 02110; Denver, CO 80112; Hopkins, MN; Keene, NH 03431; St. Joseph, MO 64507; Phoenix... ...Works with partners in pricing/actuarial, claims, etc. to ensure product compliance and...SuggestedFull timeContract workWork at officeLocal areaRelocationRelocation package$60k - $80k
Workers' Compensation Claim Adjuster Location: Hybrid or Remote, reporting to Minnetonka, MN Schedule: MondayFriday, 8:00 AM4:30 PM CST Work Arrangement: Hybrid or remote options available based on location. Occasional in-state (MN) travel for client meetings or training...SuggestedWork at officeRemote work$28 - $42 per hour
...detail oriented and have strong organization and project management skills. This role is based in the Minnetonka, MN or Irvine, CA office working in a hybrid environment in office 4 days a week with the flexibility to work remotely 1 day per week. Primary...Hourly payMinimum wageFull timeWork experience placementLocal areaRemote work1 day per week- Sedgwick Claims Management Services Ltd in Eden Prairie, MN is seeking a Disability Representative Sr. to manage complex disability claims and make critical... ...experience in claims management. The position offers a hybrid work arrangement and a comprehensive benefits package...
- ...Insurance Agent - Minneapolis, MN Join Horace Mann and unlock your financial potential Ready to take control of your financial future? At Horace Mann, we are here to support you in achieving your goals and making a meaningful difference in the lives of the educators...Work at office
- CCMSI (Cannon Cochran Management Services, Inc.) is seeking a Workers' Compensation Claim Adjuster for our Minnetonka, MN branch. The role offers the flexibility of hybrid or remote work, while managing claims across MN, SD, and WI jurisdictions. The ideal candidate should...Remote jobWork at office
$63.8k - $78k
...someone who possesses those skills to assist our clients through the claims process and to help them return to normalcy after a loss. No... ...This is an in-office position that will work out of our Edina, MN office, located at 7700 France Avenue South. A work from home option...Temporary workFor contractorsWork at officeWork from homeVisa sponsorshipWork visa- ...Claims Representative - Liability - Richfield, MN By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience...Contract workWork at officeLocal area
$39.52k - $43.68k
The Bernard Group Inc in Chanhassen, MN, is hiring a Customer Experience Specialist to maintain strong customer relationships and handle inquiries effectively. This full-time role offers a hybrid work environment and a competitive compensation range of $39,520 - $43,68...Full timeFlexible hours$88.8k - $152.3k
...of underwriting/pricing experience; strongly preferred within the PBM industry or pharmacy underwriting at a Health Plan Pharmacy... ...candidates located near one of the following office locations: Minnetonka MN, Madison WI, Omaha NE, and St. Louis MO. The full salary grade...Work experience placementWork at office3 days per week- ...Job Description Job Description Job Title:Medical Claims Specialist Location: Minneapolis, MN (Hybrid – 2 Days/Week Onsite) Employment Type:Contract-to-Hire Job Summary Seeking an experienced Critical Illness Claims Analyst to interpret policy language,...Contract workRemote work2 days per week
- Huntington Commercial Bank is looking for a Credit Underwriter Sr. - Inventory Finance to analyze the creditworthiness of customers. Responsibilities include underwriting loans, analyzing financial data, and presenting recommendations for loan approvals. The ideal candidate...
$30 - $40 per hour
...clients. The ideal candidate should have strong organizational and communication skills, preferably with prior experience in insurance. Compensation ranges from $30.00 to $40.00 per hour, with opportunities for hybrid work after six months. #J-18808-Ljbffr BrandiwarmbierHourly payPart time$88.8k - $133.25k
...Management LLC seeks a Pharmacy Underwriter Consultant in Minnetonka, MN. The role involves managing financial analysis, risk assessment,... ...'s degree and 5+ years of related experience, especially in PBM. Key responsibilities include leading RFPs and developing pricing...$20 per hour
...Call Center Representative-Bloomington, MN Job Category: Inspection Requisition Number: CALLC002813 Apply now Posted: May 21, 2026 Full-Time Locations Bloomington, MN 55420, USA Storti Quality provides critical infrastructure and inspection services to major utilities...Full timeMonday to Friday$50 per hour
...Select how often (in days) to receive an alert: Roadshow Lead Generator Minneapolis, MN What are we looking for At Stone Systems ( ) we are looking for a Brand Ambassador to generate countertop leads at Costco warehouses in the Minnesota area. We’re looking for someone...Hourly payFull timeWork at officeFlexible hoursWeekend work$279.5k
...exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the... ...collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical...Remote jobMinimum wageFull timeWork experience placementLocal area$41.5k - $101k
...using our toolbox of over 220 top named carriers Educate the community on benefits available Ensure support and follow up with claims Keep up to date with the changes in benefits available to clients Maintain excellent client relations with exceptional follow...$50k - $76k
...$76000.00 Job Category: Sales - Comparion Description We are looking for an Insurance Sales Associate to join our team in our Edina, MN office. This is not a remote position. We're Hiring Immediately! As an Insurance Sales Associate, you will work alongside with and support...Full timeWork at officeLocal areaImmediate start$20.36 - $31.3 per hour
...Administrative Assistant/Customer Service (Eden Prairie, MN -Center for Excellence) This position is responsible for providing administrative support for Center for Excellence. In addition, customer relations support for customers and internal customers. This position...Hourly payTemporary workWork at officeWorldwideFlexible hoursAfternoon shift$20.35 - $40.65 per hour
...mothers, female executives, and scientists. The Opportunity Our Abbott Nutrition Retail Sales Office located in Minneapolis, MN currently has an opportunity for an Administrative Assistant. This full-time position sits onsite in our downtown Minneapolis office...Hourly payFull timeWork at officeRemote work$64.97k - $99k
...Responsibilities Join our team as a Property Field Inspection Claim Specialist and showcase your expertise in handling accident and weather-... ...Where you'll work: This position is located in Minneapolis, MN . Competitive candidates should reside within one of the...Work experience placementWork at officeLocal areaRemote workWork from homeFlexible hours- ...Contract To Perm Opportunity Hybrid expectations into Minneapolis, MN. (2 days/week). Responsible for interpreting contract language and processing claims with high complexity. Provide a high quality of service with minimal direction, that is consistent with regulatory...Permanent employmentContract work2 days per week
$55k - $65k
...Forbes Best-in-State Employer Auto Field Appraiser- Minneapolis, MN PRIMARY PURPOSE : To handle field appraisal assignments for... ...regarding their vehicle’s cost of repair estimate and explains claims/repair process Maintains accurate vehicle’s cost of repair estimate...Remote jobWork at officeLocal areaFlexible hours$74.2k - $111.3k
...interest you? Western National is seeking a Workers' Compensation Claims Specialist to join our team! The individual in this role will have the... ...a flexible work environment, which includes a variety of hybrid and remote work arrangements designed to balance individual,...Full timeLocal areaRemote workWork visaFlexible hours$21 - $23 per hour
...Customer Service Representative (CSR) - Minnetonka, MN Customer Service Representative - Join Our Dynamic Team! Are you a positive and adaptable individual looking for a unique customer service opportunity? Do you excel in multitasking and thrive in a dynamic work...Work at officeMonday to Friday$17.5 - $25 per hour
...Hybrid Warehouse and Customer Support Rep Minneapolis - Plymouth, MN 55441-0000 Overview Salary Range $17.50 - $25.00 Hourly Position Type Full Time Description Hybrid Warehouse and Customer Support Representative Emser Tile LLC Emser Tile LLC, a national...Hourly payFull timeFor contractorsLocal areaImmediate start
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Rx Claims Specialist: PBM Mastery (Hybrid, MN). Be the first to apply!
- claims consultant Eden Prairie, MN
- insurance claims processor Eden Prairie, MN
- claim specialist Eden Prairie, MN
- remote medical claims processor Eden Prairie, MN
- claims analyst Eden Prairie, MN
- claims processor Eden Prairie, MN
- claim examiner Eden Prairie, MN
- claims assistant Eden Prairie, MN
- medical claims auditor Eden Prairie, MN
- claims administrator



