Job Summary

• Develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare.
• Ensures Medicare/Medicaid encounter submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate for Medicare/Medicaid trading partners.
• Humana offers competitive benefits that support whole-person well-being, including medical, dental, vision, 401(k), and various paid time off options.

Matching Summary

Salary

Base: $78,400 - $107,800 per year; Bonus/Equity: Eligible for bonus incentive plan; Benefits: Medical, dental, vision, 401(k), time off, disability, life insurance

Skills & Requirements

Key Requirements

• 3 years Medicare/Medicaid claims processing/auditing
• Prior fast-paced insurance/healthcare experience
• Comprehensive Microsoft Office knowledge
• Intermediate Excel skills
• Bachelor's degree preferred
• Project management experience preferred
• SQL writing/query experience preferred
• 1+ years CAS and CI experience preferred
• 1+ years X-12 data knowledge preferred
• Six Sigma certification preferred

Work Rights