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.
Medical AR Specialist - Denials Norco Inc.Medical AR Specialist - DenialsMeridian, ID$18.50–$19.50 / hourAreas of focus include submissions of claims, claim rejections, denial management, collection of current and aged insurance receivables, account adjustments, audits, account status changes, posting payments, refunds, and patient phone calls. Responsible for processing claim denials within company established timelines for a variety of denial reason codes and as well as working Accounts Receivable through reports, system programs, audits, etc.
RN Clinic Supervisor HCA Healthcare IncRN Clinic SupervisorCaldwell, ID$30.27–$45.42 / hourResponsible for work assignments and daily operations Manage staff performance and evaluations including supervising, coaching, and disciplinary action for front office and clinical staff Monitor and control clinical expenditures to remain within budget Serves as a liaison between clinic and external agencies Works with medical staff to ensure quality patient care and services are provided Maintains strict confidentiality and privacy Performs related work as required What Qualifications you will need: Education: Graduate from an accredited school or program in nursing is required Experience: A minimum of one year of experience in medical office, acute care, or clinical outpatient setting is required. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life.
Intake Specialist - Meridian, MS Vital Care Infusion ServicesIntake Specialist - Meridian, MSMeridian, 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.
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.
Sr Data Engineer Boeing Employees Credit UnionSr Data EngineerID$141,800–$173,300 / yearWorking closely with data engineers, business analysts, and systems analysts, the Sr Data Engineer builds and supports enterprise-class data pipelines and scalable cloud-based data solutions that enable operational reporting, analytics, data governance, automation, and emerging AI-driven capabilities. Demonstrated experience using SQL, data modeling, data warehousing, data analysis including designing, building and supporting enterprise scale operational data stores (ODS), data warehouses and data lake/ Lakehouse solutions.
Software Developer Boeing Employees Credit UnionSoftware DeveloperID$117,200–$143,200 / yearThe role also participates in production deployments, including serving in an on-call capacity to troubleshoot and resolve unexpected issues, which may occur outside of traditional business hours, helping to ensure system stability and successful implementation of changes. If you enjoy solving complex technical challenges, partnering with business stakeholders, and delivering solutions that create measurable value, this role offers an opportunity to make a meaningful impact while continuing to grow your expertise in a collaborative environment.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Nampa, IDRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.