Enrollment and Billing Specialist Delta Dental Of IdahoEnrollment and Billing SpecialistBoise, IdahoThe Enrollment and Billing Specialist performs a variety of general accounting and enrollment/eligibility duties including reconciling eligibility for select employer groups according to group contracts and underwriting guidelines, enrollment additions and changes, reconciling payment and billing for both groups and individuals, and providing excellent customer service. It's key to our becoming the leading dental benefits carrier in the state, reaching over 500,000 Idahoans with our dental plans and community outreach programs.
Enrollment And Billing Specialist Delta Dental Of IdahoEnrollment And Billing SpecialistBoise, IDThe Enrollment and Billing Specialist performs a variety of general accounting and enrollment/eligibility duties including reconciling eligibility for select employer groups according to group contracts and underwriting guidelines, enrollment additions and changes, reconciling payment and billing for both groups and individuals, and providing excellent customer service. It's key to our becoming the leading dental benefits carrier in the state, reaching over 500,000 Idahoans with our dental plans and community outreach programs.
Epic 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.
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.
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.
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.
Charge Master Analyst Sutter HealthCharge Master AnalystBoise, ID$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.
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.
Supervisor, Utilization Management TriWest Healthcare AllianceSupervisor, Utilization ManagementBoise, IDRemoteFull timeTechnical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.
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.
Primary Care Functional Medicine - Nurse Practitioner OnePeak Medical ProvidersPrimary Care Functional Medicine - Nurse PractitionerNampa, IdahoFunctional Medicine Training & Mentorship: Comprehensive onboarding, clinical mentorship, and ongoing training in functional and integrative medicine to support professional growth in OnePeak’s care model. Read our white paper on Evidence, Patient Demand, and the Rise of Functional Medicine to explore the research, growing patient demand, and the future of whole-person healthcare.
Revenue Cycle Manager Valley Family Health CareRevenue Cycle ManagerPayette, IDOnboarding & Ongoing Training Oversight: Work with Front Office Coordinator, Practice Managers and Patient Service Representative Leads to onboard and train employees on patient registration, scheduling appointment management, sliding fee discount, patient collections, customer service, insurance verification, benefits eligibility, and optimizing workflow efficiencies to enhance staff satisfaction and patient experience. RESPONSIBILITIES: Departmental Oversight and Management: Provide leadership and oversight to all revenue cycle departments, including registration, scheduling, Sliding Fee Program, coding, credentialing, billing, payment posting, collections, credentialing, and EHR functions as they relate to revenue cycle.
Clinical Inpatient Pharmacy Technician - Audit & Review Cambia HealthClinical Inpatient Pharmacy Technician - Audit & ReviewBoise, IDRemoteAs a member of the Post Service Claim Review team, our Clinical Inpatient Pharmacy Technicians conducts post-service audits to ensure billing accuracy, analyzes billings for consistency with medical records and reimbursement policies, and performs projects as requested by supervisors - all in service of making our members' health journeys easier. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
Epic Denials Management Coordinator DeloitteEpic Denials Management CoordinatorBoise, ID$50,000–$60,000 / yearJoin Deloitte's AI & Engineering practice to support hospital denials management to 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. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes.
Epic Denials Management Operator DeloitteEpic Denials Management OperatorBoise, ID$70,000–$90,000 / yearJoin Deloitte's AI & Engineering practice to support hospital denials management to 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. Review hospital account records and payer remittance records, communicate with relevant Client RCM and internal hospital stakeholders, and conduct outreach to payers through payer portals and phone calls to gather necessary information to understand denial reasons and root causes.
NewLead Substation Project Engineer WSP Global IncLead Substation Project EngineerBoise, IDTasks include research, engineering design, concept development, planning, and execution of medium‑ to extra‑high‑voltage substations, including power distribution, protection and control systems, grounding, and equipment integration. Any unsolicited resumes, including those submitted to hiring managers or other business leaders, will become the property of WSP and WSP will have the right to hire that candidate without reservation - no fee or other compensation will be owed or paid to the recruiter, employment agency, or other staffing service.
MDS Specialist KARCHERSNFMDS SpecialistNampa, IDPart timeEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen saver activates within established facility policy guidelines. Assist in developing procedures to ensure resident records are properly completed, assembled, coded, signed, indexed, etc., before filing.
Senior OpenText xPression, Exstream Developer-2 MaximusSenior OpenText xPression, Exstream Developer-2Boise, IDRemoteFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Candidates must meet requirements to obtain and maintain an IRS Minimum Background Investigation (MBI) clearance (active IRS Moderate Risk MBI clearance is a plus).
VP Claims & Payment Integrity Operations Blue Cross of IdahoVP Claims & Payment Integrity OperationsMeridian, IdahoRequired Education: Bachelor’s Degree in Business Administration, Healthcare Administration, Health Information Management or related field; or equivalent work experience (Two years’ relevant experience is equivalent to one-year college); Master's degree (MBA, MHA, MPH) strongly preferred. Proven track record of driving measurable savings and payment accuracy improvements through payment integrity initiatives and operational efficiency programs, with accountability for first-pass yield, financial accuracy, and payment accuracy benchmarks.
Project Manager - Eagle MTech MechanicalProject Manager - EagleEagle, IdahoOur Core Values: Integrity • Commitment • Excellence • Growth • Fun Physical Requirements: While performing the duties of this job, the employee is required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. Estimate, negotiate and implement all changes in the scope of the project; coordinate and communicate with owner, general contractor and internal personnel, all cost and schedule impacts related to the change order.