• Medicaid Provider Hospital

    Humana (Boise, ID)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
    Humana (10/21/25)
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  • Medicare (PPS) Provider Hospital

    Humana (Boise, ID)
    …part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
    Humana (10/18/25)
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  • Director, Provider Contracts (Must reside…

    Molina Healthcare (Meridian, ID)
    …* Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and ... live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development… more
    Molina Healthcare (10/05/25)
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  • Provider Contracts Manager - Complex…

    Molina Healthcare (Boise, ID)
    …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
    Molina Healthcare (10/18/25)
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  • Provider Contracting Professional 2

    Humana (Boise, ID)
    Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts + Proficiency in analyzing,… more
    Humana (10/17/25)
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  • Senior Provider Contracting Professional

    Humana (Boise, ID)
    …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... + 2+ years of network management experience including but not limited to: provider and hospital contracting, network administration in a healthcare company or… more
    Humana (10/15/25)
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  • Patient Account Representative - Treasure Valley…

    Surgery Care Affiliates (Boise, ID)
    …Meeting and maintaining cash collection metrics and goals. + Maximized facility reimbursement . + Understands each payer contract and will utilize to ensure payments ... of Benefits received from any payer. + Works closely with payer provider relations representatives. + Has thorough knowledge of ASC Allowable procedures. +… more
    Surgery Care Affiliates (08/16/25)
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  • Compliance Audit Manager

    Cardinal Health (Boise, ID)
    …audit methodology, principles and techniques; CMS manuals; professional and/or hospital services reimbursement and repayment; confidentiality standards. + ... organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: detection and correction of documentation,… more
    Cardinal Health (08/27/25)
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  • Inpatient Medical Coding Auditor

    Humana (Boise, ID)
    …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more
    Humana (09/24/25)
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  • Nurse Audit Manager

    Humana (Boise, ID)
    …ensure medical documentation and coding are precise, compliant, and support optimal reimbursement . This is an exciting opportunity to apply your advanced technical ... Applies clinical and coding experience to conduct reviews of provider codes and billing. + Decisions are typically related...or more years of clinical RN experience in a hospital setting. + 3 or more years of experience… more
    Humana (10/18/25)
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  • Inpatient Coding Quality Auditor

    HCA Healthcare (Caldwell, ID)
    …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... for our team to ensure that we continue to provide all patients with high quality, efficient care. Did...complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes are… more
    HCA Healthcare (09/27/25)
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