- Crawford & Company (Boise, ID)
- …have been settled and the claim is only open for payment of medical benefits (ie maintenance claims not requiring actuarial reserves). + Contacts, by ... Everything We Touch Position Summary Under direct supervision, processes medical only claims within authority, processes other... claims , other than "M" cases, where all medical issues have been settled and the claim… more
- Molina Healthcare (Meridian, ID)
- …business areas. **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing requirements (1500 and UB04), provider ... **JOB DESCRIPTION** **Job Summary** Analyzes complex claim inquiries and reimbursement issues.using data from internal and external sources to expeditiously resolve … more
- R1 RCM (Boise, ID)
- …& AR Senior Analyst :** + You will be investigating and analyzing claims to identify denial reasons. + Drafting complex and contractual appeals and letters to ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...and workflow orchestration. As our Denials and AR Senior Analyst , you will help R1 by managing assigned accounts… more
- R1 RCM (Boise, ID)
- …transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise ... automation, and workflow orchestration. As our Denials & AR Analyst I, you will help R1 clients by analyzing... I, you will help R1 clients by analyzing claims information so that they can resolve complex accounts.… more
- Sumitomo Pharma (Boise, ID)
- …that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into the Commercial Validata system ... dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
- Evolent (Boise, ID)
- …contribute to Evolent's broader mission. **Collaboration Opportunities:** The Senior Analyst , Performance Suite Analytics utilizes and develops analytic tools to ... impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Business Development efforts. Working in… more
- Evolent (Boise, ID)
- …as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics role will be serving key internal (Evolent Account ... + 2+ years of SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - **Required** + 2+ years of experience using Microsoft… more
- Prime Therapeutics (Boise, ID)
- …Management) experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical , and/or financial data + Basic to intermediate SAS ... decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information,… more
- Molina Healthcare (Caldwell, ID)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and… more
- Molina Healthcare (Boise, ID)
- …the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements. + Create Business Requirements ... the intended functional and operational requirements. + Analysis of claim payment to identify potential recoupment. **JOB QUALIFICATIONS** **Required Education**… more
- CVS Health (Boise, ID)
- …setup essential for online viewing and processing related to Customer Service, Claims , Enrollment, Billing and Reporting in support of internal and external ... with various data systems (DOS systems a plus) + Medical terminology knowledge + Be highly organized and able...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- CVS Health (Boise, ID)
- …solutions to make health care more personal, convenient and affordable. **Position Summary** Claim Audit Quality Analysts need to have a wide depth and breadth of ... review. A candidate must become subject matter experts in claims , plan documents, eligibility, coverages, and quirks of multiple...is imperative to be an effective auditor. The QA analyst must be able to effectively manage their time… more
- Molina Healthcare (Meridian, ID)
- …staff for mentoring, coaching, and analysis questions. + Reviews Health Plan analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting ... for strategic analysis, profitability, financial analysis, utilization patterns and medical management. + Interfaces and maintains positive interactions with Health… more