- Molina Healthcare (Meridian, ID)
- …sources. **Preferred Qualifications:** + Experience with Medicaid + Experience with medical claims , authorization, and membership data + Advanced proficiency ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and...reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments… more
- 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 (Boise, 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
- Molina Healthcare (Meridian, ID)
- …sources. + Resource to staff for mentoring, coaching, and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Medical Economics Team activities and personnel. Provides technical expertise,… more
- R1 RCM (Boise, ID)
- …accounts. Every day, you will conduct root cause analysis and gather and correct claim information to resolve insurance company medical denials. To thrive in ... you will experience working as a Denials & AR Analyst :** + Investigate and analyze physician-based claims ...claims to identify denial reasons; gather and correct claim information to resubmit claims + Contact… more
- R1 RCM (Boise, ID)
- …payor guidelines, the ability to analyze, formulate, and initiate actions to resolve claims /issues, and the overall escalation of claim issues with payors when ... transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise… 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
- 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
- R1 RCM (Boise, ID)
- …with employees throughout the US and international locations. Our Service Delivery Analyst /Ops Lead role will be responsible for backend revenue cycle focused on ... ambiguity and uncertainty as your opportunity to solve problems, innovate and deliver. The analyst /ops lead role will report to the Manager of that region in Service… more
- Prime Therapeutics (Boise, ID)
- …Project management / scrum leading experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data &...- Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting the business in decision… 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 (Meridian, 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
- St. Luke's Health System (Boise, ID)
- …from this role:** St. Luke's Health System is currently seeking a **Revenue Cycle Analyst ** to join our team under the direction of our **Revenue Cycle Manager** for ... deferred revenue reports to support internal and external requirements. + Analyzes claims data to identify contractual underpayments and billing errors. + Other… more
- Prime Therapeutics (Boise, ID)
- …our passion and drives every decision we make. **Job Posting Title** Health Informatics Analyst - Remote **Job Description** **Do you want to an opportunity to learn ... Medical Pharmacy? If you have at least 2-years of...Performs exploratory data analysis and data mining of healthcare claims and authorizations data. + Designs, documents, develops and… more
- Molina Healthcare (Meridian, ID)
- …results to identify early signs of trends or other issues related to medical care costs. Recommend solutions to identified issues. + Design and perform actuarial ... studies related to medical care costs and trends. + Design and program...analysis for senior management; effectively communicate results. + Prepare claim experience reports, rate models, and state regulatory reports.… more
- Molina Healthcare (Meridian, 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
- Molina Healthcare (Meridian, ID)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Economics, Math, or Computer Science **Preferred Experience** Preferred experience in Medical Economics and Strong Knowledge of Performance Indicators: + Proactively… more
- CVS Health (Boise, ID)
- …. Microsoft Excel Knowledge . Issue Resolution . IT Knowledge . Claims Routing Knowledge . Relationship maintenance with Vendors . Custom Provider Directory ... our colleagues and our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll in the Company's 401(k)… more
- Molina Healthcare (Boise, ID)
- …the business to provide recommendations on opportunities for process improvements, medical cost savings or revenue enhancements. + Create Business Requirements ... operational processes including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business… more