Blue Cross of Idaho

Implementation Specialist

• Analyze, manage, and implement editing and auditing concepts and customizations
• Collaborate with multiple internal business partners to identify continuous process improvement opportunities
• Monitor editing and auditing programs for trends and process improvement opportunities
• Present issues, lead and/or participate in discussions, and develop conclusions with internal and external professionals
• Provide functional requirements and work with software developers to determine solutions for projects
• Review contracts and policy language to ensure claims processing results match contract and policy terms
• Prepare and present in-depth written technical assessments
• Perform other duties and responsibilities as assigned

Payment Integrity Quality Program Implementation Specialist I/II