Coding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorID$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
Packet Review / Coding Specialist Pennant ServicesPacket Review / Coding SpecialistCaldwell, IdahoThe Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee.
Coding Supervisor | HIM | HYBRID (ON-SITE/REMOTE) Gritman Medical CenterCoding Supervisor | HIM | HYBRID (ON-SITE/REMOTE)Moscow, IDRemotePreferred Qualifications: Prefer five (5) years experience in a supervisory role in healthcare with extensive knowledge of ICD-10-CM, CPT, HCPCS, and documentation guidelines; EPIC experience, including HB and PB billing. Keeps abreast of recent technology in coding software and other forms of automation and stays informed about transaction code sets, HIPAA requirements and other future issues impacting the coding function.
NewPlans Examiner II: Code Compliance & Plan Review City of NampaPlans Examiner II: Code Compliance & Plan ReviewNampa, ID$27.73–$33.92 / hourThe successful candidate will review construction plans to ensure compliance with codes and maintain effective relationships with various stakeholders. This role offers a competitive salary of $27.73-$33.92 per hour and comes with a range of benefits, including medical, dental, vision, and retirement plans.#J-18808-Ljbffr.
Urgent Care - Partner Veterinarian - Boise , {State_Code UsvtaUrgent Care - Partner Veterinarian - Boise , {State_CodeBoise, IdahoAn exceptional veterinary hospital, with a dedicated team, is seeking an experienced Partner Veterinarian to provide leadership, superior patient and client care, and financial ownership in the hospital. The ideal leader for this hospital is a veterinarian who is prepared to manage a team of doctors and medical staff and successfully oversee the clinical direction of the practice while building equity.
Oral Maxillofacial Surgery Profee Coder HCA Healthcare IncOral Maxillofacial Surgery Profee CoderIdaho Falls, ID$20.25–$30.38 / hourApply share Share Email X Facebook LinkedIn bookmark_border Save Job bookmark Unsave Job // Save Jobs functionality detectsavedjob('1-INFOR-4468972-OTHLOC-00310','save-job','unsave-job'); You will be a key promoter of Central Coding and responsible for setting the tone of the Coding Physician Service Center as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs.
Hospital Billing Coordinator Deloitte Touche Tohmatsu LtdHospital Billing CoordinatorID$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Chargemaster Revenue Auditor PRN Knight Health Holdings LLCChargemaster Revenue Auditor PRNLewiston, IDWe're proud to be recognized for excellence and patient safety, including an "A" Hospital Safety Grade from The Leapfrog Group, inclusion in Becker's list of "Great Community Hospitals," and U.S. News & World Report accolades for maternity care. The Chargemaster Revenue Auditor is responsible for ensuring accurate and compliant coding, charging, and documentation processes that directly affect revenue integrity.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)ID$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
NewCharge Master Analyst Sutter HealthCharge Master AnalystID$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
NewEpic Resolute Hospital Billing Associate Analyst Deloitte Touche Tohmatsu LtdEpic Resolute Hospital Billing Associate AnalystBoise, ID$50,000–$60,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Billing (RCM) Supervisor BC Beacon Cancer CareBilling (RCM) SupervisorCoeur d'Alene, IdahoCoordinate system/workflow improvements and collaborate with clinical leadership, pharmacy, infusion centers, clearinghouses, collection agencies, and other vendors alongside RCM Manager. This individual will lead day-to-day revenue cycle operations for a growing multi-disciplinary practice to maximize cash flow, minimize days in A/R, and ensure accurate, compliant billing and coding.
Medical Coder - In-Patient & Out-Patient - Surgical Hospital - Treasure Valley Hospital SCA HealthMedical Coder - In-Patient & Out-Patient - Surgical Hospital - Treasure Valley HospitalBoise, IdahoAs part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.
Hospital Billing Operator Deloitte Touche Tohmatsu LtdHospital Billing OperatorID$70,000–$90,000 / yearOur purpose comes through in our work with clients that enables impact and value in their organizations, as well as through our own investments, commitments, and actions across areas that help drive positive outcomes for our communities. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Medical Coder - In-Patient & Out-Patient - Surgical Hospital - Treasure Valley Hospital Surgical Care Affiliates LLCMedical Coder - In-Patient & Out-Patient - Surgical Hospital - Treasure Valley HospitalBoise, IDAs part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Here, you'll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)ID$50,460–$72,644 / yearRequired as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Customer Service Representative Quantum RecruitersCustomer Service RepresentativeBoise, IDWork efficiently in multiple systems simultaneously while effectively utilizing critical thinking and problem solving skills. Work Experience: One-year medical insurance, other healthcare related field, call center or customer service experience required.
NewSoftware Engineer (Salesforce) (US REMOTE) Motorola Solutions IncSoftware Engineer (Salesforce) (US REMOTE)IDRemote$100,000–$110,000 / yearRequired Skills & Qualifications: Salesforce Certifications (preferred): Salesforce Certified Application Architect, Salesforce Certified Advanced Developer, Salesforce Revenue Cloud Consultant, Salesforce CPQ Specialist, or equivalent. Integration & Maintenance: Design and develop integrations between Salesforce and other enterprise systems (ERP, marketing automation, etc.) using tools like MuleSoft, REST/SOAP APIs, and middleware platforms.
Billing Specialist Terry Reilly Health ServicesBilling SpecialistNampa, IDFull timeWe provide integrated care throughout the Treasure Valley with our medical, dental and behavioral health services - allowing our employees the unique ability to experience several disciplines of health care. Ability to effectively communicate and interact with physicians and coworkers, hospital staff, third-party payors, patients and the public.
Claims Recoup & Collect Anlyst TriWest Healthcare AllianceClaims Recoup & Collect AnlystBoise, IDRemoteFull timeUnder limited supervision, manages and performs claims department activities related to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding.
NewAccounts Receivable Analyst Deloitte Touche Tohmatsu LtdAccounts Receivable AnalystBoise, ID$70,000–$90,000 / yearAs an Accounts Receivable Analyst you will deliver Back End Revenue Cycle Management (RCM) services, including Billing and Claims Submission, A/R Follow-up, Denials Management, Payment Posting, and Credits and Refunds, for health care provider client. This compensation range is specific to the remote role and takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Program Manager-Risk Adjustment Blue Cross and Blue Shield AssociationProgram Manager-Risk AdjustmentMeridian, IDRemote$86,650–$129,974 / yearCollaborate with cross-functional teams, including, Provider Engagement, Risk Adjustment Coders, Data Analysts, vendors, Quality/HEDIS, Healthcare Operations, Compliance, Legal, Marketing, Corporate Communications, IT and Procurement to streamline processes, ensure compliant timely execution and to support data integrity. The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data.
NewProfee Audit Specialist - FT DatavantProfee Audit Specialist - FTBoise, IDRemote$35–$45 / hourAs a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
Health Information Management Director HCA HealthcareHealth Information Management DirectorIdaho Falls, ID$63,793.60–$108,472 / yearPerform facility unbilled activities including physician query follow up, physician incomplete record follow-up, collaboration with facility department leaders in monitoring and working unbilled reports, working the applicable HPF/MPF queues, working the applicable unbilled management reports and queues, (e.g., DET/eRequest, Bill 49) and management of HIM operations unbilled processes. Work all applicable HPF/MPF workflow queues (includes, but is not limited to, the Facility HIM Department Queue, all Coding Pend for Queues, Review Queues, Unknown Document Queue, Cancelled Accounts Queue and all Wait for Workflow Trigger Queues) according to established workflow guidelines and schedules.
Pharmacy Services Technician Cambia Health Solutions IncPharmacy Services TechnicianIDRemote$20.50–$30.80 / hourAssist with auditing and investigations of medication-related claims, cases, and providers to identify misuse of medications, misuse of resources, substance abuse, and erroneous and fraudulent billing practices; investigate and organize workflow for claims referred to Pharmacy Services for review and allowable determination including miscellaneous J codes, providers on review, and reconsiderations. Support wellness and disease state management programs for Pharmacy Service and corporately which contribute to NCQA accreditation and ongoing quality improvement; contribute to and support the corporation's quality initiatives through process improvement teams and by encouraging team and individual contributions toward quality improvement efforts.
Specialty Care Financial Navigator Trinity HealthSpecialty Care Financial NavigatorBoise, IDResponsible for obtaining applications for assistance programs (copay and free drug) available to oncology patients and specialty care patients seen in the hospital for outpatient or inpatient infusions. Explores, recommends, and coordinates the varied financial assistance options available to patients in order to ensure the provision of the best financial resources possible for each patient in assigned specialty clinics, while maximizing revenue for the company.
NewPRACTICE MANAGER - AXIS SPINE CENTER Surgery Partners IncPRACTICE MANAGER - AXIS SPINE CENTERPost Falls, IDThe Practice Manager will ensure that fiscal functions of the department(s) are conducted in accordance with generally accepted accounting practices and specific practices as established from time to time by the hospital and the corporation. Northwest Specialty Hospital includes 12 operating rooms and 28 inpatient beds, along with a variety of clinics and services throughout Kootenai County that span across multiple specialties.
Pharmacy Care Technician - Work From Home (Idaho) CVS Health CorpPharmacy Care Technician - Work From Home (Idaho)ID$17–$25.65 / hourPharmacy Care Technicians assist with inbound phone calls; interact with customers and cross functional team to answer questions, solve problems, provide education, and maintain our company's reputation for high-quality service. In this role, you will assist in accurately reading, interpreting and entering prescriptions into the computer system including calculation of doses and assignment of directions and accepting proper insurance payment in a timely fashion.
Care Management Associate, Engagement Hub CVS Health CorpCare Management Associate, Engagement HubID$18.50–$31.72 / hourStrong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members, adhering to care management processes (to include, but not limited to, privacy and confidentiality, quality management processes in compliance with regulatory, accreditation guidelines, company policies and procedures). Aetna's Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members' needs and create behavioral change.
Billing Specialist II Terry Reilly Health ServicesBilling Specialist IINampa, IDWe provide integrated care throughout the Treasure Valley with our medical, dental and behavioral health services - allowing our employees the unique ability to experience several disciplines of health care. Ability to effectively communicate and interact with physicians and coworkers, hospital staff, third-party payors, patients and the public.
Intake Specialist Vital Care Infusion ServicesIntake SpecialistMeridian, IdahoRequired Skills/Abilities: Excellent communication skills: listening, speaking, understanding, and writing English while influencing patients, caregivers, and payer representatives, answering questions, and advancing reimbursement and collection efforts. Obtain prior authorizations; initiate requests, follow up to provide the additional required information, track progress, expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed.
Supervisor, Claims Admin TriWest Healthcare AllianceSupervisor, Claims AdminBoise, IDRemoteFull timeThe Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
Financial Support Specialist Terry Reilly Health ServicesFinancial Support SpecialistNampa, IDFull timeManages returned mail, including but not limited to; researching for better addresses, suspending statements, handling balances on accounts, and research with statement and collections vendors. Mange participation and verification of income for patients elected to receive additional funding from grants or programs such as; Patient Assistance Fund, CHCNI, CDV, CHOIS.
Business Development Executive (MedInsight) Milliman IncBusiness Development Executive (MedInsight)Boise, IDRemote$120,635–$199,065 / yearMedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions. Primary Responsibilities: Develop deep expertise in MedInsight's risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.
Per Diem Pharmacy Technician UnitedHealth Group IncPer Diem Pharmacy TechnicianNampa, IDClinical ›Corporate and business operations ›Customer and support services ›Early careers›Sales and account management ›Technology and data›Physicians›Advanced practice clinicians›Pharmacy›Behavioral health›Nursing›Medical coding›Clinical support›U.S. Technology and data Artificial intelligence Architecture Business systems analysis Data analytics Data engineering Data science Network infrastructure Product management & development Security and risk Software engineering.
Field Reimbursement Manager - Kidney (Pacific Northwest - WA, OR, ID, WY, MT, AK) Vertex Pharmaceuticals IncField Reimbursement Manager - Kidney (Pacific Northwest - WA, OR, ID, WY, MT, AK)ID$136,000–$204,000 / yearKey Duties and Responsibilities: Compliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.
Sr Claims Reviewer TriWest Healthcare AllianceSr Claims ReviewerBoise, IDRemoteFull timeProficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.
Claims Reviewer TriWest Healthcare AllianceClaims ReviewerBoise, IDRemoteFull timeProficient with claim and coding tools and resources, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and/or the Claims Subcontractor as needed.
Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical CareDialysis Clinical Manager Registered Nurse - RNCoeur D Alene, IDPHYSICAL DEMANDS AND WORKING CONDITIONS:** + Day-to-day work includes desk and personal computer work and interaction with patients, facility staff, and physicians + Position may require travel between assigned facilities and various locations within the community and/or travel to regional, business unit, and corporate meetings may be required. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease.
Utilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerBoise, IDRemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Pediatrician Health West IncPediatricianPocatello, IDFosters a spirit of collaboration, education and cooperation amongst the medical staff including direct supervision of nurse practitioners and physician assistants (in accord with State Boards of Nursing and Medicine regulations) as needed, consultation with medical colleagues as requested, including other HW clinicians and maintains flexibility to meet schedule and patient needs. Supports the Health West Director of Quality, the Director of Behavioral Health, the Chief Operations Officer, and other personnel as they implement workflows and other processes aimed at improving nursing, reception, behavioral health, prescription assistance, and outreach care.
Provider Services Business Office Pennant ServicesProvider Services Business OfficeEagle, IdahoRemoteWe are a collection of independent, locally led healthcare companies united by a shared purpose and the CAPLICO values-Celebration, Accountability, Passion, Love, Intelligence, Customer Second, and Ownership. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US.
NewCertified Medical Assistant / Specialized Family Medicine Portneuf HealthCertified Medical Assistant / Specialized Family MedicinePocatello, IdahoGet to Know Your Team: Portneuf Medical Center is a nationally recognized healthcare leader with 205 beds, serving as the region's tertiary care and Level II Trauma Center, housing the Portneuf Heart and Vascular Institute, Portneuf Cancer Center, Portneuf Medical Group, and Portneuf Air Rescue. Patient visit support that may include: Greeting patients and escorting patient to exam room and/or taking patients’ vital signs and other applicable medical information to effectively support the reason for the patients visit and recommended treatment.
NewCertified Medical Assistant / CMA Rheumatology Portneuf HealthCertified Medical Assistant / CMA RheumatologyPocatello, IdahoGet to Know Your Team: Portneuf Medical Center is a nationally recognized healthcare leader with 205 beds, serving as the region's tertiary care and Level II Trauma Center, housing the Portneuf Heart and Vascular Institute, Portneuf Cancer Center, Portneuf Medical Group, and Portneuf Air Rescue. Patient visit support that may include: Greeting patients and escorting patient to exam room and/or taking patients’ vital signs and other applicable medical information to effectively support the reason for the patients visit and recommended treatment.
NewCertified Medical Assistant / CMA Primary Care Ardent Health Partners LLCCertified Medical Assistant / CMA Primary CarePocatello, IDGet to Know Your Team: Portneuf Medical Center is a nationally recognized healthcare leader with 205 beds, serving as the regions tertiary care and Level II Trauma Center, housing the Portneuf Heart and Vascular Institute, Portneuf Cancer Center, Portneuf Medical Group, and Portneuf Air Rescue. Provides superior patient care and performs administrative and delegated clinical tasks that support patients in a clinic-based environment as part of a care team led by the physician and/or advanced practice provider.
Sr. Software Engineer - AI Innovation Team Boeing Employees Credit UnionSr. Software Engineer - AI Innovation TeamID$141,800–$173,300 / yearWHAT YOU'LL DO: Build AI‑Powered Features: Develop and implement moderate to complex application features and services, including high‑impact components that integrate AI/ML models or AI service APIs. From integrating machine learning models and generative AI services to guiding best practices and architecture decisions, your work will directly influence performance, innovation, and long-term technical direction.
Accounts Receivable Specialist United Wound HealingAccounts Receivable SpecialistIDRemote$24–$27 / hourClaims Knowledge: Strong ability to read and understand EOBs; deep understanding of insurance denials and unresolved claims resolution; knowledge of ICD-10, CPT, HCPCS, and CMS-1500 claim format. Investigate and resolve unresolved claims (denials, underpayments, delayed payments); troubleshoot claim data and submit written appeals with supporting documentation and timely follow-up.
NewMRI Technologist - Tellica Boise, ID Intermountain Health IncMRI Technologist - Tellica Boise, IDBoise, ID$39.16–$60.42 / hourFrequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations. American Registry of Radiologic Technologists (ARRT)(MR) or American Registry of Magnetic Resonance Imaging Technologists (ARMRIT) or American Registry of Radiologic Technologists (ARRT)(R) cross-trained in MRI.
NewPayment Integrity Nurse I Cambia Health Solutions IncPayment Integrity Nurse IBoise, IDRemote$73,230.90–$99,077.10 / yearAs a member of the Post Service Claim Review team, our Payment Integrity Nurse I conducts post service review of claims in prepayment, post payment or audit capacity to ensure appropriate clinical review, reimbursement of claims and accuracy of coding. Excellent computer skills and proficiency working software programs (i.e. Microsoft Word, Excel, and PowerPoint); learn new processes and systems quickly.
NewMedicaid Utilization Review Analyst - MED State of IdahoMedicaid Utilization Review Analyst - MEDCoeur dAlene, IDAs an analyst, you will play a crucial role in conducting preliminary investigations by reviewing claims data and medical records, reviewing provider billing practices, conducting provider and participant interviews, and ensuring that Medicaid services are billed and paid in accordance with Medicaid rules and regulations. This position will communicate findings and provide program education to Medicaid providers through written and oral communication, recovering identified overpayments, assessing civil monetary penalties and taking other administrative actions when warranted.