Blue Cross of Idaho is looking for a Payment Resolution Specialist to acts as primary investigator for provider inquiries and appeals related to Supplier and Payment Integrity audits. The Payment Integrity Resolution Specialist will be evaluating appeal details, making determinations and communicating complex medical and reimbursement information to providers within contractual requirements and plan policy.
We are looking for a Payment Integrity Resolution Specialist with:
Level I:
3 years' health industry or related experience
Level II:
4 years' health industry or related experience
Licenses/Certifications: Recognized Coding Certification
What a day of a Payment Integrity Resolution Specialist looks like:
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