- Elevance Health (Meridian, ID)
- **Title: Grievance / Appeals 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 ** Grievance / Appeals Representative I** is responsible for reviewing, analyzing and processing claims in… more
- CVS Health (Boise, ID)
- …+ Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system . + ... Educates & assists providers on our self-service options. Assists providers with credentialing and re-credentialing and contracting questions and issues. + Assists in compiling claim data for customer audits. Determines medical necessity, applicable coverage… more