- 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 (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
- 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 (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
- 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
- Cardinal Health (Boise, ID)
- …Managed Care oversees the interactions that take place between payer and provider (s) to ensure optimal reimbursement including managed care contracting, ... Functions:** + Responsible for documenting and tracking all credentialing, re-credentialing, provider enrollment, and hospital privileging activities within the… more
- 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
- Molina Healthcare (Meridian, ID)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Meridian, ID)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- 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