- Lincoln Financial (Boise, ID)
- …reviews for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. ... You will analyze and manage a caseload of appeals claims . You will review, investigate, and...+ Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims… more
- Molina Healthcare (ID)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... Experience in the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific… 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)
- …answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims . To thrive in this role, Appeals Specialist incumbents must be ... pertaining to the EOB. + Works closely with third party payers to resolve unpaid claims in proving medical necessity of the patient's admission. + Works with HIM… 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
- 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
- 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
- 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
- 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