- Prime Therapeutics (Boise, ID)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Claims Lead **Job Description Summary** Adjudicate or submit claims and ... cause analysis and provide additional training as needed. Resolve claims edits and suspended claims . **Job Description**...and administrative duties as required by business need. + Lead and implement positive changes with a high level… more
- Humana (Boise, ID)
- …of our caring community and help us put health first** The Senior Pharmacy Claims Professional adjudicates pharmacy claims and process pharmacy claims for ... data requires an in-depth evaluation of variable factors. The Senior Pharmacy Claims Professional oversees processes and ensures accuracy for pharmacy point of sale… more
- UMB Bank (Boise, ID)
- **Duties & Responsibilities** The Manager, Card Fraud Claims , will oversee and manage the UMB card fraud claims process, ensuring timely and accurate resolution ... of fraud cases. The role will lead a team of fraud analysts and assist in...and assist in developing strategies to mitigate card fraud claims risk. This role will also assist with the… more
- Enterprise Mobility (Boise, ID)
- …business line of Enterprise Mobility is excited to announce the opening of a Claims Support Coordinator! The Claims Support Coordinator serves as the primary ... claim from first notice of loss through resolution. The Claims Support Coordinator handles inbound communication from clients regarding... with group personnel and customer + Participate and lead prospect calls and customer training upon request +… more
- Elevance Health (Meridian, ID)
- **Title: Claims Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our ... PulsePoint locations. The ** Claims Representative I** will be responsible for successfully completing...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- HealthEdge Software Inc (Boise, ID)
- …**Your Impact** **: ** + Develop the product roadmap forclaimsvalue stream and lead high-level epic planning for current and futurequarters + Lead and ... and coordinate delivery of multiple product features across multiple engineeringteams + Lead engineering grooming sessions for selected epics and stories + Work… more
- HealthEdge Software Inc (Boise, ID)
- …**REQUIRED HOURS: Full-time.** **REQUIRED DUTIES:** + Develop the product roadmap for claims value stream and lead high-level epic planning for current ... commercialization and organization enablement of features that the team creates. + Lead and define high-level business requirements for all assigned epics working… more
- Takeda Pharmaceuticals (Boise, ID)
- …therapies to patients worldwide. Join Takeda as Associate Director, Global Labeling Lead where you will be responsible for the development and implementation of ... Cross-Functional Team (GLOC) + In alignment with TAU/MPD Labeling Lead , coordinates the process to obtain labeling approval by...to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure… more
- Elevance Health (Meridian, ID)
- **Title: Grievance/Appeals Analyst Lead ** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of a ... PulsePoint location. The **Grievance/Appeals Analyst Lead ** will be responsible for leading and coaching a...and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize… more
- Simplot (Boise, ID)
- Regulatory Lead HQ AB Location: Boise, ID, US, 83702 The JR Simplot Company is a diverse, privately held global food and agriculture company headquartered in Boise, ... cattle production, and other enterprises related to agriculture. **Summary** The Regulatory Lead - Wholesale and Retail Agriculture will manage all aspects of… more
- SMX (Boise, ID)
- Lead Buyer (3727)at SMX(View all jobs) (https://www.smxtech.com/careers/) United States SMX is seeking a skilled ** Lead Buyer** to provide buying support for our ... order. * Negotiates and settles with vendors regarding damage claims , rejections, losses, return of materials, overages, cancellations, and...* Provides guidance to less experienced Buyers. * May lead a small team of Buyers on large programs… more
- Humana (Boise, ID)
- …services. **Responsibilities:** The Value-Based finance team is seeking a Financial Analytics Lead . This individual will work across the business, and will be highly ... to support critical business decisions and optimize outcomes. + Lead design and development of Power BI reporting and...to leadership. + Partner with DH&A team to evaluate claims data to drive deeper insights into the business… more
- Nucor Steel Auburn, Inc. (Boise, ID)
- …company. Short Description Nucor Rebar Fabrication is in search of an Inside Sales Lead to support our sales department. This person adds value by leading our inside ... has full knowledge of the market. + Assist in the resolution of claims and disputes between Nucor Rebar Fabrication and customers. + When necessary, assist… more
- Trinity Health (Nampa, ID)
- …Supervisor, Patient Access. + Processes insurance claim forms. + Reviews claims /accounts for complete information, corrects and completes forms to ensure accuracy. ... information and translates data into information acceptable to the claims processing system. + Prepares claims for...Identifies routine payer or provider issues and escalates to Lead Patient Financial Services Representative. + Acts as a… more
- Trinity Health (Boise, ID)
- …Supervisor, Patient Access. + Processes insurance claim forms. + Reviews claims /accounts for complete information, corrects and completes forms to ensure accuracy. ... information and translates data into information acceptable to the claims processing system. + Prepares claims for...Identifies routine payer or provider issues and escalates to Lead Patient Financial Services Representative. + Acts as a… more
- Valor Health (Emmett, ID)
- …Title: Revenue Cycle Manager Position Summary: Process primary and secondary claims electronically or paper format with complete information to reduce denials ... Registration when needed. + Electronically bills primary payers. Files secondary claims . Reconstructs claims when necessary or insurance information becomes… more
- Guardian Life (Boise, ID)
- **Job Posting Title** **Team Leader, Absence Claims Management** **Job Description** The **Team Leader, Absence Claims Management** is responsible for leading a ... submit process improvement ideas to revise workflows and procedures. + Support claims initiatives by encouraging/providing relevant feedback and acting as a change… more
- Norstella (Boise, ID)
- …visionary Senior Director of RWD (Real-World Data) Analytics and Innovation to lead real-world data special projects, such as building multimodal datasets, piloting ... integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health (SDoH) data, to drive… more
- Elevance Health (Meridian, ID)
- …The **Grievance/Appeals Representative I** is responsible for reviewing, analyzing and processing claims in accordance with policies and claims events to ... providers and/or others for resolution or affirmation of previously processed claims . + Ensures appropriate resolution to inquiries, grievances and appeals within… more
- R1 RCM (Boise, ID)
- …will be responsible for managing and improving key components such as claims processing, coding, billing, payment posting, collections, and denial management. Every ... strategies to optimize revenue cycle processes and improve financial performance. + Lead and mentor a team of revenue cycle professionals, fostering a culture… more