UNKNOWN

FEED

To determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford.

Based in Atlanta, Georgia, Crawford &amp; Company is the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with an expansive global network serving clients in more than 70 countries. 

The Crawford System of Claims Solutions(SM) offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines, including property and casualty claims management, workers compensation claims and medical management, and legal settlement administration 

The Company's shares are traded on the NYSE under the symbols CRDA and CRDB.

Crawford & Co

Claims Specialist-WC

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This role owns the health, stability, and compliance posture of a suite of clinical and regulatory R&D platforms - including Axway Secure Transport (ST), eClinical Elluminate, Eclipse (medical coding), and EAST - across the full engagement lifecycle: implementation, configuration, validation, and steady-state managed services. The team operates at the intersection of IT infrastructure, clinical operations, and quality/regulatory compliance, partnering closely with global business and technology stakeholders to support end-to-end clinical trial data lifecycles from data capture and coding through statistical analysis and submission-ready outputs.

YEAR

Deloitte Touche Tohmatsu Ltd

Clinical Data AMS Sr. Consultant

Explores, recommends, and coordinates the varied financial assistance options available to patients in order to ensure the provision of the best financial resources possible for each patient in assigned specialty clinics, while maximizing revenue for the company. Responsible for obtaining applications for assistance programs (copay and free drug) available to oncology patients and specialty care patients seen in the hospital for outpatient or inpatient infusions.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. It is a family of 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, the Trinity Health system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations and many other health and well-being services. In fiscal year 2023, the Livonia, Michigan-based health system invested $1.5 billion in its communities in the form of charity care and other community benefit programs.

Trinity Health

Specialty Care Financial Navigator

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Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple perpetrators or intricate healthcare fraud schemes. Demonstrates high level of knowledge and expertise during interactions and acts confidently when providing testimony during civil and criminal proceedings.

CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all.

CVS Health Corp

Senior Investigator, Special Investigations Unit (Aetna SIU)

Deloitte

The Patient Financial Services Supervisor provides leadership, training, coaching, and performance management for assigned staff while monitoring key performance indicators related to accounts receivable, denials, prior authorizations, financial assistance, cash collections, and medical records operations. Monitors key performance indicators, including cash collections, accounts receivable days, clean claim rates, denial rates, appeal success rates, authorization performance, financial assistance activity, and medical records turnaround times.

Valor Health

PATIENT FINANCIAL SERVICES SUPERVISOR

The FRL interfaces with healthcare professionals, including their ancillary staff, nurse case managers (NCMs), HUB coordinators, Market Access team, and various Channel Partners on complex access and reimbursement cases by providing education on Crinetics sponsored patient programs and process guidance in response to prior authorizations, resubmissions, and denials. Essential Job Functions and Responsibilities: These may include but are not limited to: Conduct office calls with HCPs and/or office staff for support with appropriate patient access to Crinetics' products, including assistance in resolving reimbursement, patient programs, and coverage questions.

Crinetics Pharmaceuticals Inc

Field Reimbursement Liaison - Northwest

The Patient Financial Services Supervisor provides leadership, training, coaching, and performance management for assigned staff while monitoring key performance indicators related to accounts receivable, denials, prior authorizations, financial assistance, cash collections, and medical records operations. The Patient Financial Services Supervisor oversees the daily operations of billing, collections, payment posting, accounts receivable follow-up, denial management, appeals, financial assistance, prior authorizations, and medical records functions.

Patient Financial Services Supervisor

FULL_TIME

OTHER

Applies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.

TriWest Healthcare Alliance

Utilization Clinical Reviewer

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Our Claims Examiners are intellectually disciplined in applying, analyzing, and evaluating information gathered to determine the validity and compensability of claims received and work strictly within the program's statutes and guidelines. Idaho's Crime Victims Compensation Claims Examiners review bills as they are received to ensure expenses are crime-related and work with health care providers if additional detail is needed.

State of Idaho

CRIME VICTIMS CLAIMS EXAMINER

In this role, you will be responsible for analyzing, programming, debugging, building, deploying, testing, and documentation of applications in development and production environments, as well as database design and system testing and documentation. Expected deliverables include requirement analysis, system analysis, system design, data models, program design, source code development, unit test case development, unit and system testing, and documentation.

Cambia Health

Data Platform Engineer III (Hedis Support)

Cambia Health Solutions is a family of companies headquartered in Portland, Oregon, working to create a person-focused and economically sustainable health care system. 

Through our health plans, innovative technology and strategic investments, we are delivering consumer-centric solutions that:

•       help people achieve better health and well-being 
•       make health care more available, affordable and accessible 
•       are easily understood by everyone

We put people at the heart of everything we do. Our company reaches more than 70 million Americans nationwide, including more than two million people in the Pacific Northwest who are enrolled in our regional health plans.  

Cambia Health Solutions Inc

Data Platform Engineer III (HEDIS Support)

The successful candidate will collaborate with cross-functional enterprise teams, provide technical leadership, and leverage deep expertise in iOS development and Apple Health technologies to deliver secure, high-quality, and customer-centric digital products. CVS Health Digital is looking for hands-on, passionate people who want to join a high energy and growing team to make a difference in customers' lives and who want to be on the forefront of digital innovation that aims to reinvent what a pharmacy and a health care company can be in the digital world.

Staff Software Development Engineer - iOS

Complies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).

Program Integrity Investigator

Provides consultation on business requirements and functional specifications in logical program designs, code modules, application systems, and software solutions; facilitates the transition to high level design and supports the project lifecycle with input from leadership where needed. Serves as a technical lead for project teams throughout the implementation and maintenance of business and enterprise software solutions by leveraging partnerships with technology teams and business leaders to resolve escalated issues.

Old Dominion Freight Line Inc

Application Delivery Technical Lead

Architect and deliver production-grade agentic AI and multi-agent applications using popular frameworks such as LangChain, LangGraph, AutoGen, CrewAI, or Semantic Kernel; design patterns including orchestrator-agent hierarchies, RAG pipelines, tool-calling agents, and context/memory management. Our purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities.

Software Engineer III- AI & Engineering/Software as a Service

Software Engineer Iii- AI & Engineering/Software As A Service

Demonstrated Fluency in AI-Assisted Development : Candidates must be able to demonstrate practical, hands-on experience using AI-powered coding tools to achieve specific, quantifiable productivity gains, while also clearly understanding and mitigating the associated risks (e.g., code quality, security, IP concerns). Evolution of the Engineering Role: A well-articulated point of view on how your role has already changed (e.g., new workflows, skills, ways of collaborating) due to the introduction of AI and how you expect the role to evolve in the coming years based on your assessment of coming advancements in AI tools and technologies.

Coding Manager Jobs in Boise, ID

Claims Specialist-WC Crawford & Co

Clinical Data AMS Sr. Consultant Deloitte Touche Tohmatsu Ltd

Specialty Care Financial Navigator Trinity Health

Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health Corp

Clinical Data AMS Sr. Consultant Deloitte

PATIENT FINANCIAL SERVICES SUPERVISOR Valor Health

Field Reimbursement Liaison - Northwest Crinetics Pharmaceuticals Inc

Patient Financial Services Supervisor Valor Health

Utilization Clinical Reviewer TriWest Healthcare Alliance

CRIME VICTIMS CLAIMS EXAMINER State of Idaho

Data Platform Engineer III (Hedis Support) Cambia Health

Data Platform Engineer III (HEDIS Support) Cambia Health Solutions Inc

Staff Software Development Engineer - iOS CVS Health Corp

Program Integrity Investigator TriWest Healthcare Alliance

Application Delivery Technical Lead Old Dominion Freight Line Inc

Software Engineer III- AI & Engineering/Software as a Service Deloitte Touche Tohmatsu Ltd

Software Engineer Iii- AI & Engineering/Software As A Service Deloitte

Program Integrity Investigator TriWest Healthcare Alliance

Application Delivery Technical Lead Old Dominion Freight Line Inc

Senior Full Stack Engineer Vynyl

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