- Humana (Boise, ID)
- …part of our caring community and help us put health first** The Claims Research & Resolution Representative 2 manages claims operations that involve ... the resolution to a pending call.** The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and… more
- Intermountain Health (Boise, ID)
- …payments to patient accounts, using both electronic and manual posting systems + Research , validate and make adjustments to payment postings. Follow up in accordance ... procedures and policies with an overall goal of account resolution + Post correspondence, zero payments, denials and any...additional items received from insurance to patient accounts + Research and follow-up on missing information, such as EOB… more
- Molina Healthcare (Boise, ID)
- …member/provider impact and engagement including: Appeals and Grievances, Problem Research and Resolution , and the development/maintenance of Member/Provider ... of the call/ issue and following it through to resolution , on behalf of the customer, in real time...wide variety of inquiries and assistance involving their benefits, claims , premiums, and other areas including very complex issues.… more
- Magellan Health Services (Boise, ID)
- …payment policies, Medicaid/Medicare rules and statutes, etc. + Conduct research on medical policies and practices, provider characteristics, and related ... methodologies, and relevant laws to find suspicious patterns in claims data, provider enrollment data, and other sources +...findings of potential fraud, waste and abuse + CASE RESOLUTION + Identify, communicate and recover losses as deemed… more
- City of Boise (Boise, ID)
- …Civil Focus: Areas of emphasis may include contract, code, ordinance and resolution writing; real property transactions; legal research and writing assignments; ... law and open meetings laws + Tort and tort claims laws; International Fire Code and Idaho law regarding...legal documents + Review, proof and critique the legal research and opinions of others + Operate a computer… more