63,943 Health Insurance Specialist jobs in the United States

**16923BR**
**Title:**
Health Insurance & Authorization Specialist I
**Department/Cost Center:**
846 - Business Office/Cashiers
**Job Description:**
he Health Insurance and Authorization Specialist is responsible to assess and perform quality control function for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, inquires on prior auth denials and works with the Provider's office to resolve, requests estimated cost and collects deposits for non-covered services, ensures appropriate medical justification is documented for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates MSP questions, monitors Medicare days for exhausted benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests
**Salary Range:**
$19.62 - $26.49 an hour
_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._
**Auto req ID:**
16923BR
**Job Requirements:**
1. Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience
2. Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and or knowledge of third-party insurance regulations.
3. Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.
**Employment Status:**
Full-Time
**Hours/Week:**
40hrs
**Posting Title:**
Health Insurance & Authorization Specialist I
**City:**
Rochester
**Work Shift:**
Days
**Area of Interest:**
Clerical
The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.

**16795BR**
**Title:**
Health Insurance & Authorization Specialist I
**Department/Cost Center:**
846 - Business Office/Cashiers
**Job Description:**
The Health Insurance and Authorization Specialist is responsible to assess and perform quality control function for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, inquires on prior auth denials and works with the Provider's office to resolve, requests estimated cost and collects deposits for non-covered services, ensures appropriate medical justification is documented for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates MSP questions, monitors Medicare days for exhausted benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests
**Salary Range:**
$19.62 - $26.49 an hour
_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._
**Auto req ID:**
16795BR
**Job Requirements:**
1. Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience
2. Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and or knowledge of third-party insurance regulations.
3. Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.
**Employment Status:**
Full-Time
**Hours/Week:**
40
**Posting Title:**
Health Insurance & Authorization Specialist I
**City:**
Rochester
**Work Shift:**
Days
**Area of Interest:**
Clerical
The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.

**Working Title: Health Insurance Recovery Specialist**
**Job Class: Human Services Program Specialist 2**
**Agency: Human Services Dept**
+ **Job ID** : 89335
+ **Location** : St. Paul
+ **Telework Eligible** : Yes
+ **Full/Part Time** : Full-Time
+ **Regular/Temporary** : Unlimited
+ **Who May Apply** : Open to all qualified job seekers
+ **Date Posted** : 10/02/2025
+ **Closing Date** : 10/08/2025
+ **Hiring Agency/Seniority Unit** : Human Services Dept / MAPE DHS Central Office
+ **Division/Unit** : Health Care Administration / Health Care Integrity and Accountability
+ **Work Shift/Work Hours** : Day Shift / 8:00am - 4:30pm
+ **Days of Work** : Monday - Friday
+ **Travel Required** : No
+ **Salary Range:** $26.43 - $8.55 / hourly; 55,185 - 80,492 / annually
+ **Classified Status** : Classified
+ **Bargaining Unit/Union** : 214 - MN Assoc of Professional Empl/MAPE
+ **FLSA Status** : Nonexempt
+ Designated in Connect 700 Program for Applicants with Disabilities ( : Yes
The Department of Human Services is unable to provide sponsorship for work visas. Applicants must be eligible to work in the United States at the start of employment. DHS does not participate in E-Verify.
**The work you'll do is more than just a job.**
At the State of Minnesota, employees play a critical role in developing policies, providing essential services, and working to improve the well-being and quality of life for all Minnesotans. The State of Minnesota is committed to equity and inclusion, and invests in employees by providing benefits, support resources, and training and development opportunities.
**This position is eligible for telework for applicants who reside in Minnesota or in a bordering state, with supervisory approval and satisfactory performance. If you live in a state bordering Minnesota, you must live within 50 miles or less from the primary work location to be eligible for telework.**
***This posting may be used to fill multiple openings***
This position is responsible for assuring that Medicaid is the payer of last resort in cases where a third party such as medical/dental/vision/pharmacy/long term care insurance exists. The position administers the Third Party Liability (TPL) program, which is the Medicaid program responsible for cost avoidance and recovery as required by federal and state law.
Responsibilities include:
+ Audit, review and analyze daily and monthly reports containing third party liability information to ensure accuracy, flag anomalies and resolve discrepancies.
+ Coordinate and account for the daily activities associated with the payment or denial of Medicaid benefits.
+ Correspond in writing and by phone with providers and clients to ensure the proper coordination of benefits.
+ Formally communicate policy and procedure and respond to inquiries from internal and external stakeholders regarding TPL and the cost effective health insurance (CEHI) program.
+ Track, receive, document and process payments from third party payers.
+ Coordinate with the lead worker and supervisor to address and communicate ongoing business needs.
**Minimum Qualifications**
One (1) year professional Third Party Liability, Minnesota Health Care Program (MHCP) eligibility, or health care claims experience.
**OR**
Three (3) years advanced technical experience requiring knowledge of Third Party Liability, MHCP eligibility and/or claims processing.
Experience must clearly demonstrate:
+ Database management skills sufficient to navigate databases and systems, multiple software applications and screens.
+ Ability to efficiently manage time and apply logic in a work environment requiring fast and accurate response to time sensitive work load.
+ Excellent customer relations skills to provide information in a professional and courteous manner to consumers, communication includes phone calls, email and letter correspondence.
***Bachelor's degree in Healthcare Administration, Business Administration, Social Services or related field may substitute for two (2) years of advanced technical experience***
**Preferred Qualifications**
+ Familiarity with Minnesota Health Care Programs
+ Experience using MMIS, MAXIS or METS
+ Ability to examine program costs, services and impacts to analyze and interpret program information
+ Variety of experiences working effectively with others from different backgrounds and cultures
**Additional Requirements**
To facilitate proper crediting, please ensure that your resume clearly describes your experience in the areas listed and indicates the beginning and ending month and year for each job held.
REFERENCE/BACKGROUND CHECKS - The Department of Human Services will conduct reference checks to verify job-related credentials and criminal background check prior to appointment.
AN EQUAL OPPORTUNITY EMPLOYER
Minnesota State Colleges and Universities is an Equal Opportunity employer/educator committed to the principles of diversity. We prohibit discrimination against qualified individuals based on their race, sex, color, creed, religion, age, national origin, disability, protected veteran status, marital status, status with regard to public assistance, sexual orientation, gender identity, gender expression, or membership in a local commission as defined by law. As an affirmative action employer, we actively seek and encourage applications from women, minorities, persons with disabilities, and individuals with protected veteran status.
Reasonable accommodations will be made to all qualified applicants with disabilities. If you are an individual with a disability who needs assistance or cannot access the online job application system, please contact the job information line at or email . Please indicate what assistance is needed.