Utilization Review Technician

All about us

You likely know us as an insurance company, but that's just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It's a mission we take seriously.

We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.

Our Strategic Affiliation with Cambia
In 2026, BCBSND and Cambia Health Solutions formed a strategic affiliation to enhance access to simpler, more affordable health care while keeping a strong local focus. The affiliation was approved by North Dakota regulators and became effective Feb. 1, 2026. Under this affiliation, BCBSND employees became Cambia employees while continuing to serve the BCBSND market. Daytoday work and hiring continue as usual.

Work environment

This opportunity is open to a hybrid, or in-office working arrangement, in Fargo, ND. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND.

Pay information

• Pay Level: 019
• FLSA Category: Nonexempt - Hourly
• Individual pay will be based on skills, experience, qualifications, location, internal equity, and other relevant factors.
• Opportunities for continued salary growth through a performance-based merit program.
• The estimated starting pay for this position is $22.00 - $29.00/hr.

At BCBSND, we're committed to providing fair and equitable compensation. While the posted salary range reflects the full compensation range for this role, offers typically fall at or below the midpoint, and in alignment with internal equity and role expectations. Individual offers are based upon candidates' unique experience, education, and skillsets. The top of the range reflects the ceiling for this role and is only used for offers in exceptionally rare cases. We do not extend offers above the posted maximum.

A day in the life

The Utilization Review Technician is responsible for providing support for care coordination, network, referrals, and other pre- and post-service requests by receiving, reviewing, and acting on requests from service providers for medical procedures, treatments, and medications.

Your responsibilities will include

• Receives and reviews incoming preservice requests from services providers and prioritizes workload to ensure timeliness standards and inventory reviews are maintained.
• Responds and resolves requests within scope of practice following standard communications protocols. Refers cases to appropriate nursing staff for further review if necessary.
• Acts as a resource to internal and external customers for non-medical aspects of utilization management review.
• Researches and provides both written and/or oral communication to internal and external customers and providers in a professional manner.
• Provides support by performing benefit analysis, data analysis, interpretation of suspensions, and entering information into multiple systems with accuracy and maintaining reference documents as appropriate.
• Completes daily claims inventory, collects, and prepares data/reports with accuracy and in a timely manner to appropriate staff members.
• Answers questions and responds to a variety of inquiries, provides information requiring working knowledge of policies and procedures, and resolves questions or problems relating to assigned area.

What you need to succeed

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  Associate's degree in health care administration, business, general studies or related field is required

  
  
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  Bachelor's degree is strongly preferred

  
  
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  3 years in medical office-setting, health insurance, or related experience is required

  
  
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  Knowledge of health insurance and medical terminology, coding, healthcare, insurance, claims processing or related experience is preferred

  
  
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  Demonstrated ability to communicate clearly and effectively in both verbal and written formats

  
  
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  Foundational technical and professional knowledge with the ability to learn and apply new concepts

  
  
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  Strong collaboration skills with the ability to work effectively across teams

  
  
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  Sound basic decisionmaking skills with the ability to identify appropriate next steps

  
  
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  Proven ability to engage professionally and effectively with customers

  
  
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  Exceptional attention to detail and a high degree of accuracy in all work

  
  

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Benefits

• Affordable medical, dental and vision coverage accepted throughout the United States
• Employer funded Lifestyle Spending Accounts and Health Savings Accounts. Voluntary employee contributions to Health Savings Accounts and Flexible Spending Accounts
• Employer-paid life and disability insurance
• 401(k) retirement plan with company match and immediate vesting
• Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
• Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more.

Additional company perks

• Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ.
• Comprehensive learning and development opportunities and an Educational Assistance Program.
• 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Opportunities to connect through employee committees.

Equal opportunity employment

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

For questions, please email careers@bcbsnd.com.

Application Deadline: This posting is scheduled to close on 4/03/2026 at 8:00 a.m. (CT). However, it may be closed earlier if a high volume of qualified applications is received. We encourage interested candidates to apply promptly.

This position is not eligible for employment-based visa sponsorship. Candidates must be legally authorized to work in the United States at the time of application and for the entire duration of employment without the need for sponsorship.