- HCA Healthcare (Caldwell, ID)
- …**Introduction** Do you want to join an organization that invests in you as a Medical Insurance Claims Appeals Representative? At Parallon, you come ... you have the opportunity to make a difference. We are looking for a dedicated Medical Insurance Claims Appeals Representative like you to be a part of… more
- Humana (Boise, ID)
- … Medical Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems ... Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Humana (Boise, ID)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc. +… more
- R1 RCM (Boise, ID)
- …Denials Consultant, you will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...contractual provisions and applicable state and federal laws, writing appeals and letters to insurance companies to… more
- Humana (Boise, ID)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
- Intermountain Health (Boise, ID)
- … follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims , and all aspects of insurance follow-up and collections. + ... responsible for performing a variety of complex duties, including working outstanding insurance claims follow-up for no response, unresolved from payors, and/or… more
- Cardinal Health (Boise, ID)
- …billing queue as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and ... **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- R1 RCM (Boise, ID)
- …you will conduct root cause analysis to draft appeal letters to resolve any insurance company medical denials and perform adjustments and closures. To thrive in ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...contact payers to learn the status of previously resubmitted claims , written appeals , or updates on incoming… more
- R1 RCM (Boise, ID)
- …day, you will conduct root cause analysis to craft appeal letters to resolve any insurance company medical denials. To thrive in this role, you must excel in ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...contact payers to learn the status of previously resubmitted claims , written appeals , or updates on incoming… more
- Intermountain Health (Boise, ID)
- … follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims , and all aspects of insurance follow-up and collections. + ... Submit requested medical information to insurance carrier. Responsible for the analysis and necessary corrections of invoices or accounts and maintaining work… more
- Cognizant (Boise, ID)
- …for discrepancies. + Communicate directly with payers to follow up on outstanding claims , file technical appeals , resolve payment variances, and ensure timely ... following benefits for this position, subject to applicable eligibility requirements: + Medical /Dental/Vision/Life Insurance + Paid holidays plus Paid Time Off +… more
- St. Luke's Health System (Boise, ID)
- … insurance plan design and terminology (deductible, max out of pocket, co- insurance , etc.) + Interpret medical terminology and accurately process prior ... and third-party issues such as prior authorization, step therapy, reviewing denied claims , and processing overrides. Works with an interdisciplinary team of pharmacy… more
- Highmark Health (Boise, ID)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary ... through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. +… more
- Cardinal Health (Boise, ID)
- …BS or equivalent experience in related field preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred + 1-2 years ... the patient journey. + Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier. + Exhibit effective communication and… more
- Evolent (Boise, ID)
- …culture. **What You'll Be Doing:** **Analyst, Client Analytics** Integrate and analyze claims and enrollment data from multiple sources using SAS and SQL programs. ... innovative analytics solutions that drive decision-making for clients by performing medical economics analyses to determine cost and utilization drivers. Showcase… more