Top 207 Eligibility specialist Jobs in Idaho

Senior Claim Benefit Specialist - Remote
CVS Health —Idaho
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
AUTHORIZATION AND ELIGIBILITY SPECIALIST
Marimn Health —Plummer, ID
- HIPAA
- Mid-level
- High school diploma or GED
- Paid holidays
- Disability insurance
Certified Professional Coder, Special Investigations Unit (Aetna SIU)
CVS Health —Idaho
- $43,888 - $93,574 a year
- Full-time
- Remote
- Microsoft Excel
- Research
- Mid-level
- Health insurance
- Dental insurance
Intake Specialist (In-Office if Local / Remote if Non-Local)
UNITED WOUND HEALING PS —Boise, ID
- $19 - $23 an hour
- Overtime
- Microsoft Outlook
- Pass drug screening
- HIPAA
- AD&D insurance
- Paid holidays
Quick Apply
Enrollment and Billing Specialist
Delta Dental Of Idaho —Boise, ID
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Office
- Continuing education credits
- Paid holidays
Quick Apply
4d
AUDIT INTEGRITY - CLINICAL DOCUMENTATION SPECIALIST
MOUNTAIN VIEW HOSPITAL LLC —Idaho Falls, ID
- Full-time
- Hospital
- Mid-level
- High school diploma or GED
- Paid holidays
- Health insurance
Quick Apply
COMPLIANCE AND POLICY SPECIALIST
MOUNTAIN VIEW HOSPITAL LLC —Idaho Falls, ID
- Full-time
- Hospital
- Mid-level
- 3 years
- Paid holidays
- Health insurance
Quick Apply
MEDICAL IMAGING - SCHEDULER/INSURANCE SPECIALIST
IDAHO FALLS COMMUNITY HOSPITAL LLC —Idaho Falls, ID
- Full-time
- Hospital
- BLS Certification
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
6d
Denials Management Specialist
Pennant Services, Inc. —Eagle, ID
- Full-time
- Nursing
- Microsoft Excel
- RN License
Quick Apply
11d
Technical Records Specialist 1
State of Idaho —Idaho
- $17.94 an hour
- Full-time
- Research
- Office
- Analysis skills
- Paid parental leave
- Paid holidays
3d
Lead Equipment Specialist
United Site Services —Boise, ID
- $17.64 - $23.81 an hour
- Full-time
- CDL B
- Customer service
- CDL A
- Health savings account
- AD&D insurance
Administrative Assistant/Billing Specialist
Hope Center Clinic —Boise, ID
- $18 - $21 an hour
- Part-time
- HIPAA
- Clinic experience
- Bachelor's degree
- Employee discount
Quick Apply
7d
Accounting Specialist
Idaho Milk Products —Jerome, ID
- Full-time
- Microsoft Outlook
- Customer service
- ERP systems
- Paid holidays
- Disability insurance
Parts Specialist
O'Reilly Automotive Stores —Meridian, ID
- Full-time
- ASE Certification
- Merchandising
- Cleaning
- Employee stock purchase plan
- Health insurance
Quick Apply
Parts Specialist
O'Reilly Automotive Stores —Boise, ID
- Full-time
- ASE Certification
- Merchandising
- Cleaning
- Employee stock purchase plan
- Health insurance
Quick Apply
Parts Specialist
O'Reilly Automotive Stores —Nampa, ID
- Full-time
- ASE Certification
- Merchandising
- Cleaning
- Employee stock purchase plan
- Health insurance
Quick Apply
Parts Specialist
O'Reilly Automotive Stores —Eagle, ID
- Full-time
- ASE Certification
- Merchandising
- Cleaning
- Employee stock purchase plan
- Health insurance
Quick Apply
Dental Patient Care Coordinator + AR Specialist
Rocky Mountain Endodontics - Boise —Boise, ID
- $24 - $26 an hour
- Full-time
- Dental office
- HIPAA
- Mid-level
- Health savings account
- Paid holidays
Quick Apply
Financial Professional
New York Life Insurance Company —Boise, ID
- $117,359 a year
- Full-time
- Hybrid work
- US work authorization
- Entry level
- Disability insurance
- Health insurance
Quick Apply
9d
Sales Professional
Mattress Firm —Meridian, ID
- $64,000 - $78,000 a year
- Full-time
- Ability to lift 50 pounds
- US work authorization
- Leadership
- Health insurance
- Dental insurance

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eligibility specialist jobs near idaho

Senior Claim Benefit Specialist - Remote

CVS Health -
Idaho

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Job Details

Full-time
$18.50 - $42.35 an hour

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

High school diploma or GED
Health insurance knowledge

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience.

Additional Responsibilities

Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise.
Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures.
Identifies and reports potential overpayments, underpayments, and other claim irregularities.
Performs claim rework calculations as needed.
Trains and mentors as needed to enhance team performance and technical proficiency.
Conducts outbound calls to obtain required information for claims or reconsideration requests.

Required Qualifications

Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator.
Proven success working in a high‑volume, production‑driven environment.
Demonstrated ability to manage multiple assignments with accuracy, efficiency, and attention to detail.

Preferred Qualifications

Self-Funding experience
DG system knowledge

Education

High School Diploma required
Preferred Associates degree or equivalent work experience.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

eligibility specialist jobs in idaho

Senior Claim Benefit Specialist - Remote

AUTHORIZATION AND ELIGIBILITY SPECIALIST

Certified Professional Coder, Special Investigations Unit (Aetna SIU)

Intake Specialist (In-Office if Local / Remote if Non-Local)

Enrollment and Billing Specialist

AUDIT INTEGRITY - CLINICAL DOCUMENTATION SPECIALIST

COMPLIANCE AND POLICY SPECIALIST

MEDICAL IMAGING - SCHEDULER/INSURANCE SPECIALIST

Denials Management Specialist

Technical Records Specialist 1

Lead Equipment Specialist

Administrative Assistant/Billing Specialist

Accounting Specialist

Parts Specialist

Parts Specialist

Parts Specialist

Parts Specialist

Dental Patient Care Coordinator + AR Specialist

Financial Professional

Sales Professional

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