- Cardinal Health (Boise, ID)
- …as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and accurate ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Surgery Care Affiliates (Boise, ID)
- …change. If you join our team, they will. Responsibilities The Patient Account Representative will be responsible for thorough and timely patient account follow up ... and after procedures. + Works all denials and corrected claims collaborating with the biller and/or Business Office Manager,...experience in a medical office as a patient account representative . + Candidate MUST HAVE knowledge of medical billing,… more
- Molina Healthcare (ID)
- …* Provides coordination and processing of pharmacy prior authorization requests and/or appeals . * Explains point-of-sale claims adjudication, state, NCQA and CMS ... members and providers with initiating verbal and written coverage determinations and appeals . * Records calls accurately within the pharmacy call tracking system. *… more
- Highmark Health (Boise, ID)
- …of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more