Rx Claims SME - W2 Only
Saransh Inc
Role Rx Claims SME Location Eden Prairie - MN; hybrid Position Type W2 Position Name / Department Benefit Administration-PBM Pharmacy Claims Job Description In depth knowledge on RxClaim Adjudication, claims processing, MedD claims Deep knowledge of PBM concepts, including drug pricing, copays, accumulators, and Drug Utilization Review (DUR) Knowledge on business & plan configuration and plan option knowledge. Facilitate discussion with Product Owners, Business and clarify business requirements High level knowledge in executing root cause analysis, managing data validation, and navigating automated database systems/reporting tools. Experience Years of Experience: 10.00 Years of Experience #J-18808-Ljbffr Saransh Inc
- ...Jobs via Dice is seeking an Rx Claims SME for a hybrid role in Eden Prairie, Minnesota. The candidate will manage claims processing, facilitate discussions with Product Owners, and possess deep knowledge of PBM concepts and drug pricing. Strong skills in data validation...Claims
- ...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...Claims
- ...Rxclaim / Pbm Claims Sme Pharmacy Benefits (Medd / Adjudication Expert) Our client, a IT Services and Consulting company, is looking for a RxClaim / PBM Claims SME Pharmacy Benefits (MedD / Adjudication Expert) for their Eden Prairie, MN/ Hybrid location. Requirements...Claims
- ...not limited to WFM, Consumer Resolution Center (CRC), Product, Claims, Call Ops, IT, Sales, Enrollment, Implementation, and Provider Ops... ...level leaders. Skills ~ Business Analysts role ~ Excel SME ~ some Data Analysis/Snowflake/Databricks ~2 years of business...ClaimsFor contractors
- TechDigital Group, located in Eden Prairie, 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...Claims
$120k - $250k
...neighborhood networking, perform exterior inspections, assist homeowner in claim process or retail quote. Enter data using our mobile canvass... ...in-between! Careers Icon Positions are full time, W2 positions! We invite you to build and advance your career with...ClaimsFull timeFor contractorsWork at officeLocal areaImmediate startDay shiftAfternoon shift- ...Old Republic Title Company is seeking an Associate Claims Counsel to evaluate and manage title insurance claims nationwide. This role is ideal for entry-level attorneys looking to apply their legal training in a collaborative environment. The position requires a Juris...ClaimsRemote work
- A leading claims adjusting firm is seeking Independent Insurance Claims Adjusters in Minnetonka, MN. The role involves helping clients recover from disasters while providing flexibility and competitive compensation. Candidates can be experienced or new and will receive...Claims
- A leading claims adjusting firm in Minnesota is looking for Independent Insurance Claims Adjusters. This role provides an opportunity to assist individuals and businesses in recovery from disasters while offering flexible work conditions, autonomy, and competitive pay....ClaimsFlexible hours
$20.36 - $25.24 per hour
...Starkey Laboratories, Inc. in Eden Prairie is seeking a Claims Specialist to support insurance claims operations. The role requires verifying claim accuracy, ensuring compliance with pricing and contracts, and resolving claim issues with payers and patients. Candidates...ClaimsHourly pay$80k - $100k
Old Republic National Title Insurance is looking for an Associate Claims Counsel to manage and resolve title insurance claims across the United States from a hybrid role in Minnetonka. This entry-level position is ideal for new attorneys eager to gain practical experience...Claims- C000 Old Republic National Title Insurance Company is searching for an Associate Claims Counsel to evaluate, manage, and resolve title insurance claims across the United States. This entry-level role is perfect for newly graduated attorneys who have passed the bar and...Claims
$20.36 - $25.24 per hour
...Starkey Hearing Technologies is seeking a Claims Specialist in Eden Prairie, Minnesota. This role involves supporting operations through the verification and submission of insurance claims, ensuring accuracy and compliance. Candidates should have a high school diploma...ClaimsHourly pay$20.36 - $25.24 per hour
...Starkey Hearing in Eden Prairie, Minnesota is seeking a Claims Specialist dedicated to supporting operations and ensuring insurance claim accuracy. The ideal candidate has a High School diploma (Bachelor’s preferred) and relevant experience in medical insurance billing...ClaimsHourly pay- ...Senior Claims Examiner Driasi is an ambitious, innovative and fast-paced company. We offer exceptional training and development programs, competitive pay, great benefits, all within an engaging, fun, and collaborative work environment. The staff in Driasi has the unique...ClaimsTemporary workWork at office
$91.7k - $163.7k
...Qualifications Medicare experience Experience giving formal presentations Experience in data analytics and drawing insights Experience in Rx Claim Experience in IQPR Experience in MediSpan Experience in Reporting 360 All employees working remotely will be required to adhere to...ClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work$20.36 - $25.24 per hour
...We are looking for a hard‑working, detail‑oriented Claims Specialist who will support Start Hearing operations, systems, and financial objectives. The role involves back‑end verification and submission of insurance claims, ensuring accuracy, completeness, and contractual...ClaimsHourly payContract workTemporary work$80k - $100k
## Associate Claims CounselApplylocations: MN, Minnetonka (11055 Wayzata Blvd, Ste 250): CO (Remote): NE (Remote): OK (Remote): TX (Remote)time type: Full timeposted on: Posted Yesterdayjob requisition id: R-4016**Job Description:**Are you a skilled legal professional...ClaimsMinimum wageWork at officeLocal areaRemote workFlexible hours$23 - $25 per hour
...patient scheduling and records Schedule and confirm appointments for multiple providers in the office File patient insurance claims and follow up on outstanding claims, verification of benefits and explanation of coverage Post insurance and patient payments and...ClaimsDaily paidWork at officeLocal area- ...Bell Bank is seeking a Claims Specialist in Minneapolis, Minnesota. The role involves managing the intake, review, processing, and oversight of multi-line insurance claims, ensuring fair and timely claims resolution for clients. Candidates should have a Bachelor's degree...Claims
- Job Description Old Republic Title is seeking an Associate Claims Counsel to evaluate, manage, and resolve title insurance claims nationwide. This role is suited for entry‑level attorneys, including freshly graduated law students who have passed the bar, and offers a practical...ClaimsWork at officeLocal areaFlexible hours
$20.36 - $25.24 per hour
...Temp Claims Administrator Starkey is a world leader in the manufacturing and distribution of advanced hearing technologies. We are in the business of connecting people and changing lives. Our teams come to work each day focused on ensuring people everywhere have the...ClaimsHourly payContract workTemporary workWorldwide$60.2k - $107.4k
...with billing, editing, and denials teams to investigate and resolve claim holds, rejections, and denials Analyze trends in denials or payer... ...in pro-fee coding 1+ years in supervisory or lead experience (SME experience will be considered for qualification) and the ability...ClaimsMinimum wageFull timeWork experience placementLocal areaRemote work$100k - $350k
...Sales representative to promote and sell windows, siding, and roofing. Key responsibilities include educating homeowners about the claims process, conducting home inspections, and maintaining customer communication. Ideal candidates will have experience in construction...Claims$100k - $350k
...selling roofs, with the potential to earn between $100,000 and $350,000 annually. Responsibilities include educating homeowners on claims, conducting inspections, and collaborating with the production team to maintain service quality. Applicants with experience in construction...Claims$100k - $350k
...professionals to sell residential roofing and exterior systems in Minnetonka, Minnesota. The role involves educating homeowners on claims, conducting inspections, and ensuring top-notch customer service. Candidates should have a background in roofing or construction sales...Claims- A leading claims adjusting firm is seeking Licensed Claims Adjusters to join their team in the United States. This role offers the chance to help rebuild lives affected by disasters, along with the flexibility and autonomy of claims adjusting. Candidates are encouraged...Claims
$279.5k
Texas Health Institute is seeking a Medical Director to oversee clinical review processes and ensure cost-effective care for members. This remote position requires an M.D. or D.O. with active licenses and board certification in Internal Medicine. The role demands strong...ClaimsRemote work- ...Page Mechanical Group, Inc. is looking for a Reimbursement Appeals Coordinator to manage prior authorization and claim denial appeals for the Walkasins System. Responsibilities include reviewing denial communications, gathering and submitting documentation, and tracking...Claims
$80k - $150k
...Sales Person to join their team in Minnetonka, MN. This role involves selling roofing to homeowners and assisting them throughout the claims process. The company offers commission-based earnings from $80,000 to $150,000 annually, along with bonuses for performance. Ideal...Claims
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