Jobs
>
Boise

    Appeals Case Manager II - Boise, United States - Idaho State Job Bank

    Idaho State Job Bank background
    Description


    Appeals Case Manager II at Guardian Life in Boise, Idaho, United States Job Description P os ition S u mma ry Guardian is seeking individuals with Group Disability claims experience to join our dynamic Appeals Team.

    The Appeals Case Manager II (ACM 2) is responsible for adjudicating assigned appeals for Group Life and Disability claims.

    The ACM 2 provides a full and fair reconsideration review, as required under the Employee Retirement Income Security Act (ERISA), by thoroughly assessing the claim file and applying plan provisions in accordance with applicable state and federal regulations.

    This role supports Group Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals.

    Y o u a re A highly motivated and reliable individual who is able to work with varying levels of supervision - independently or collaboratively.

    You are detail-oriented and a decisive decision maker who is able to manage multiple priorities at the same time with a positive attitude.

    Y o u ha v e
    • A minimum of 5 years of Group Disability and/or Life claims experience.
    • A minimum of 3 years of experience handling appeals or complex claims (preferred).
    • Bachelor's Degree (preferred) or equivalent professional experience.
    • A client focus with excellent verbal and written communication skills.
    • Strong problem solving, analytical, math aptitude and information research skills.
    • Demonstrated ability to manage multiple tasks in accordance with regulatory requirements.
    • The ability to remain flexible due to changing business needs.
    You w i ll
    • Utilize effective claim management skills to plan, implement and execute the investigation of disputed claims; ensure timely and compliant appeal resolution.
    • Identify and interpret relevant plan language and thoroughly investigate all claim issues to make an accurate and non biased appeal determination.
    • Evaluate medical, financial, and other claim information in consultation with clinical/vocational professionals for the purpose of resolving disputes.
    • Utilize proactive outreach to provide superior customer service to all internal and external customers.
    • Identify legal and/or compliance scenarios that require additional research; facilitate resolution.
    • Maintain current knowledge of all ERISA and Department of Labor guidelines.
    • Independently prioritize workload based on individual and departmental deadlines.
    - Readily share insights and learnings with claims To view full details and how to apply, please login or create a Job Seeker account

  • ADN Healthcare

    Case Manager

    1 week ago


    ADN Healthcare Boise, United States Travel

    We are looking for a Travel Case Manager - RN RN for a great Travel nursing job in Boise, ID. · This Case Manager - RN Travel nursing job pays for 40 hours a week for 8 weeks. With Wanderly you can compare Travel nurse salary from leading Travel nurse agencies in the United State ...

  • GEO Reentry Services LLC.

    case manager

    1 week ago


    GEO Reentry Services LLC. Boise, United States Full time

    Benefits Information · ***Now Hiring with a Sign On Bonus Payable in Quarterly Installments*** · Full-time employees will enjoy a competitive benefits package with options for you and your family including: · • Paid Time Off · • 14 Paid Holidays + Birthday Holiday · • 401(k) Mat ...


  • Idaho State Job Bank Boise, United States

    Case Management Associate at Sedgwick in Boise, Idaho, United States Job Description Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having ...

  • Universal Health Services

    Intern Case Manager

    3 weeks ago


    Universal Health Services Boise, United States

    Responsibilities · The Intern-Case Manager/Therapist works with a multidisciplinary team, including psychiatrists, nurses, mental health techs, and others, to help stabilize patient's mental health and substance abuse crisis. As a team member in Social Services, this person will ...


  • Clarvida, LLC Boise, ID, United States

    · CBRS/Case Manager - Community Based Services Professional · About your role: · Our CBRS and Case Management providers deliver services to clients at their home and in the community focusing on their individual behavioral health and/or mental health needs. This position works w ...

  • RISE INC FAMILY

    Case Manager

    1 week ago


    RISE INC FAMILY Boise, United States

    Job Details · Job Location · Boise, ID - Boise, ID · Position Type · Full Time · Education Level · Bachelors Degree in Related Field · Salary Range · $ $24.00 Hourly · Travel Percentage · Up to 25% · Job Shift · Days · Job Category · Health & Human Services · Descri ...

  • Aureus Group

    Case Manager

    1 week ago


    Aureus Group Boise, United States

    Top rated facility in BOISE, ID in need of a CASE MANAGER for a 8 WK travel assignment.Position: Case ManagerSpecialty/Modality: Case ManagementLicenses/Certifications: State License-RN-IdahoPhysical Abilities: Up to 20lbsTravel the country while you enhance your clinical skills, ...

  • One Love Agency

    Case Manager

    3 weeks ago


    One Love Agency Boise, United States

    Job Description · Job DescriptionWe are seeking dedicated and compassionate individuals to join our team as Case Managers (CM) and Community Based Rehabilitative Specialists in Idaho. As a leading provider of community-based services, we are committed to supporting individuals in ...


  • Idaho State Job Bank Boise, United States

    Senior Fraud Case Manager at Guidehouse in Boise, Idaho, United States Job Description Job Family : Investigation Consulting Travel Required : Up to 10% Clearance Required : Ability to Obtain Public Trust What You Will Do : This Senior Fraud Case Manager is responsible for modeli ...


  • Idaho State Job Bank Boise, United States

    Social Work Case Manager at Elevance Health in Boise, Idaho, United States Job Description WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed ...

  • Oklahoma Human Services

    Case Manager I/II

    2 days ago


    Oklahoma Human Services Ada, United States

    Job Description · Job DescriptionCase Manager I/II · This position is located in Ada, Oklahoma. · Annual Salary: · Level I H21A - $ 40, Full State Employee Benefits · Level II H21B - $43, Full State Employee Benefits · Travel is Extensive - Must possess a valid driver's license a ...


  • St. Luke's Health System Boise, ID, United States

    Overview · At St. Luke's, our dedicated team of Case Managers are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which ultimately drives our exceptional, pati ...


  • St. Luke's Health System Boise, ID, United States

    **Overview** · At St. Luke's, our dedicated team of Case Managers are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which ultimately drives our exceptional, ...

  • Radiant Ventures

    Case Manager

    7 hours ago


    Radiant Ventures Idaho City, United States

    We are a renowned law firm with 40 locations nationwide and internationally, specializing in restructuring and insolvency law. Our team of 500 employees is dedicated to providing successful legal services. · Administrative Assistant (m/f/d) for Consumer Proceedings - Location: Ha ...


  • UHS Boise, United States

    Responsibilities · Intermountain Hospital is looking for a dynamic Inpatient Program Therapist/Case Manager to work with a variety of patients If you have a desire to work in an engaging environment with a team of professionals dedicated to the healing and health of the patient ...


  • St. Luke's Health System Boise, United States

    Overview · At St. Luke's, our dedicated team of RNs strive to build a positive, supportive, and inclusive culture that delivers exceptional patient experiences. · St. Luke's home health team of skilled professionals provides comprehensive health care in the warmth and comfort of ...


  • Universal Health Services Boise, United States

    Responsibilities Intermountain Hospital is looking for a dynamic Outpatient Program Therapist/Case Manager to work with a variety of patients If you have a desire to work in an engaging environment with a team of professionals dedicated to the healing and health of the patients w ...

  • CorVel Corporation

    Medical Case Manager

    1 month ago


    CorVel Corporation Idaho, United States OTHER

    The Medical Case Manager coordinates resources and creates flexible, cost-effective options for ill or injured individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return-to-work if appropriate. The Medical Case Manager will r ...


  • Idaho State Job Bank Boise, United States

    Team Leader, LTD Claims Case Management at Guardian Life in Boise, Idaho, United States Job Description The LTD Team Leader is responsible for validating that all LTD claims are accurately and fairly adjudicated according to plan provisions, established best practices and within ...


  • Primary Behavioral Health Services Boise, United States

    Job Description · Job DescriptionPrimary Behavioral Health Services is a new outpatient behavioral health agency serving our growing number of Idaho residence with one vision. To embark on a path with our community and to ensure compassion, acceptance, respect, empowerment, and s ...