- Sedgwick (Boise, ID)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY ... PURPOSE** **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury … more
- CVS Health (Boise, ID)
- …following: + Executes both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from ... claim processing and customer service that impact customer satisfaction, medical cost management, and operational efficiency. Consults cross-functionally with other… more
- CRC Insurance Services, Inc. (ID)
- …of America) **Please review the following job description:** Analyzes and processes claims by gathering information and drawing conclusions. Acts as a liaison ... between insured and insurance carrier to report, track and manage claims process. Provides leadership to all employees within the claims department. **ESSENTIAL… more
- St. Luke's Health System (Boise, ID)
- …of colleagues, St. Luke's is truly a great place to work. **Overview:** The Senior Pharmacy Benefits Specialist assists our members in identifying and navigating ... and third-party issues such as prior authorization, step therapy, reviewing denied claims , and processing overrides. Works with an interdisciplinary team of pharmacy… more
- CVS Health (Boise, ID)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- CVS Health (Boise, ID)
- …dollar amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, ... Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance… more
- CVS Health (Boise, ID)
- …do it all with heart, each and every day. **Position Summary** The ** Senior Accounts Receivable Specialist ** prepares accounting and financial records and ... monthly invoices in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim system. **Required Qualifications** + 2+… more
- Mass Markets (ID)
- …passion for building strategic partnerships and driving revenue? We're seeking a Senior Business Development Executive to lead new client acquisition, manage key ... + Client Acquisition & Relationship Building Identify, qualify, and engage senior business leaders through outbound calls, emails, social media, and networking.… more
- Molina Healthcare (Meridian, ID)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- HCA Healthcare (Caldwell, ID)
- …care like family! Jump-start your career as an Inpatient Coding Resolution Specialist today with Parallon. **Benefits** Parallon, offers a total rewards package that ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more