- Humana (Boise, ID)
- …based on business needs. **Preferred Qualifications** + Bachelor's Degree + Prior claims processing experience + Overpayment experience + Financial recovery ... community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages...(Spanish / English) (see Language Proficiency Testing below)** + ** 1 or more years of Call Center or Telephonic… more
- Molina Healthcare (Meridian, ID)
- …Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains ... point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any...call center member relations. Required Qualifications * At least 1 year related experience, including call center or customer… more
- Ryder System (Boise, ID)
- …action plans if deficiencies are noted. Monitors staff's workflow to ensure accurate processing of claims , timely establishment of reserves, reviews and logs ... : **SUMMARY** This position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling… more
- CVS Health (Boise, ID)
- …key payers to discuss reimbursement issues and payer publication notices affecting claims processing changes + Ensure daily reconciliation of electronic claim ... representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances,… more