Top 65 Claims Analyst Jobs in Hopkins, MN

IBR Clinical Appeals Analyst - Remote
Optum —Plymouth, MN
- $35 - $63 an hour
- Overtime
- Remote
- Microsoft Word
- Nursing
- RN License
1d
Claims Analyst - REMOTE
Ryder System —Saint Paul, MN
- $90,000 - $100,000 a year
- Full-time
- Remote
- Customer service
- Bachelor's degree
- Experience equivalent to degree accepted
- Disability insurance
- Health insurance
PFS Contract Variance Analyst, Denials Analysis
Hennepin Healthcare —Minneapolis, MN
- $32.36 - $48.54 an hour
- Full-time
- Remote
- Psychiatry
- HIPAA
- Research
- Disability insurance
- Health insurance
Self Insured Banking Analyst
CVS Health —Saint Paul, MN
- $43,888 - $102,081 a year
- Full-time
- Hybrid work
- Basic math
- Mid-level
- Office
- Health insurance
- Dental insurance
7d
Payroll & Benefits Analyst
CITY & COUNTY CREDIT UNION —Minnetonka, MN
- $30.15 - $45.22 an hour
- Microsoft Outlook
- OSHA
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
2d
Senior Network Pricing Analyst - National Remote
Optum —Eden Prairie, MN
- $60,200 - $107,400 a year
- Full-time
- Remote
- Pass drug screening
- Mid-level
- 3 years
6d
Epic Professional Billing Systems Analyst - Remote
Optum —Eden Prairie, MN
- Full-time
- Hybrid work
- Pass drug screening
- Mid-level
- Office
R&D Analyst
Solventum —Eagan, MN
- $83,600 - $114,950 a year
- Full-time
- Hybrid work
- Oracle
- Marketing
- 5 years
- Health savings account
- Disability insurance
Business Integration Analyst - Claims Operations Automation
Blue Cross and Blue Shield of Minnesota —Eagan, MN
- $68,900 - $113,700 a year
- Hybrid work
- Mid-level
- Office
- 3 years
- Health insurance
- Dental insurance
Associate Quality Analyst
Optum —Eden Prairie, MN
- $58,800 - $105,000 a year
- Full-time
- Computer Science
- Writing skills
- Pass drug screening
PFS Contract Variance Analyst Sr, Denials Analysis
Hennepin Healthcare —Minneapolis, MN
- $34.32 - $51.48 an hour
- Full-time
- Psychiatry
- HIPAA
- Research
- Disability insurance
- Health insurance
Revenue Cycle Analyst
MN Adult & Teen Challenge —Minneapolis, MN
- $52,000 - $57,000 a year
- Hybrid work
- Background check
- Clean driving record
- Addiction Medicine
- Health savings account
- Disability insurance
Coding Quality Analyst
Optum —Plymouth, MN
- $24 - $43 an hour
- 8 hour shift
- Remote
- Microsoft Excel
- Microsoft Outlook
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
Revenue Cycle Solutions Analyst
HHAeXchange —Minneapolis-Saint Paul, MN
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- Salesforce
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Payment Integrity Coding Analyst
HealthPartners/GHI —Bloomington, MN
- $61,505.60 - $92,248.00 a year
- Full-time
- Anatomy knowledge
- HIPAA
- Research
- Health insurance
Value Based Care Data Analyst
HealthPartners/GHI —Bloomington, MN
- $50.32 - $75.48 an hour
- Full-time
- Computer Science
- Mid-level
- Office
- Health insurance
Principal Healthcare Analyst - Quality & Stars
Blue Cross and Blue Shield of Minnesota —Eagan, MN
- $102,400 - $174,200 a year
- Hybrid work
- 5 years
- Office
- Master's degree
- Health insurance
- Dental insurance
Senior Healthcare Analyst - Quality & Stars
Blue Cross and Blue Shield of Minnesota —Eagan, MN
- $90,800 - $149,800 a year
- Hybrid work
- Office
- Master's degree
- High school diploma or GED
- Health insurance
- Dental insurance
Workers Compensation and Leaves Administration Analyst
Loram Maintenance of Way —Hamel, MN
- 7 years
- Microsoft Excel
- Mid-level
Data & Pricing Analyst
Auer Steel & Heating Supply —Minneapolis, MN
- $55,000 - $80,000 a year
- Full-time
- Mid-level
- Office
- Finance
- Paid jury duty
- Health insurance
Quick Apply
10d

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Claims Analyst jobs near Hopkins, MN

IBR Clinical Appeals Analyst - Remote

Optum -
Plymouth, MN

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Job Details

Full-time
$35 - $63 an hour
1 day ago

Qualifications

Appeals
Confidential information handling
National Correct Coding Initiative (NCCI) guidelines
RN License
Regulatory compliance
Health policy
Medical insurance appeals management
Insurance claims auditing
Insurance claims appeal handling

Full Job Description

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The Itemized Bill Review (IBR) Clinical Appeals Reviewer will analyze and respond to client and/or hospital claim review appeal inquiries. Handles medical record review, analyzes data, and completes the response resolution for clients and the business unit. Must utilize expertise in auditing to review and provide response to appeals. We are seeking self-motivated, solution-oriented and skilled problem solver who provides clinical reviews with written documentation under tight deadlines.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Analyze scope and resolution of IBR Appeals
Respond to Level one, two or higher appeals
Perform complex conceptual analyses
Identifies risk factors, comorbidities', and adverse events, to determine if overpayment or claim adjustment is needed
Reviews governmental regulations and payer protocols and / or medical policy to recommend appropriate actions
Researches and prepares written appeals
Exercises clinical and/or coding judgment and experience
Collaborates with existing analysts, quality and leadership team to seek to understand, and review medical records pertaining to impacted claims
Navigates through web-based portals and independently utilizes other online tools and resources including but not limited to word, adobe, excel
Serve as a key resource on complex and / or critical issues and help develop innovative solutions
Define and document / communicate business requirements

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Undergraduate nursing degree
Unrestricted RN (registered nurse) license
2+ years of appeals experience (coding or auditing)
Experience with CPT-4 coding, NCCI edit resolution and appropriate modifier use
Advanced experience with regulations, compliance and composing professional appeal responses
Advanced experience with ICD10 CM coding and ICD 10 PCS coding
Willing or ability to work our normal business hours of 8:00am - 5:00pm
Proven ability to keep all company sensitive documents secure (if applicable)
Have a dedicated work area established that is separated from other living areas and provides information privacy
Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Preferred Qualifications:

Clinical claim review experience
Managed care experience
Investigation and/or auditing experience
Advanced experience using Microsoft Excel with the ability to create/edit spreadsheets, use sort/filter function, and perform data entry
Knowledge of health insurance business, industry terminology, and regulatory guidelines

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $35 - $63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Apply Now

Refine Your Search

Claims Analyst jobs in Hopkins, MN

IBR Clinical Appeals Analyst - Remote

Claims Analyst - REMOTE

PFS Contract Variance Analyst, Denials Analysis

Self Insured Banking Analyst

Payroll & Benefits Analyst

Senior Network Pricing Analyst - National Remote

Epic Professional Billing Systems Analyst - Remote

R&D Analyst

Business Integration Analyst - Claims Operations Automation

Associate Quality Analyst

PFS Contract Variance Analyst Sr, Denials Analysis

Revenue Cycle Analyst

Coding Quality Analyst

Revenue Cycle Solutions Analyst

Payment Integrity Coding Analyst

Value Based Care Data Analyst

Principal Healthcare Analyst - Quality & Stars

Senior Healthcare Analyst - Quality & Stars

Workers Compensation and Leaves Administration Analyst

Data & Pricing Analyst

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