Professional in Senior Encounter Data Management

Description

The Senior Encounter Data Management Professional develops business strategies to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. They make sure encounter submissions meet or surpass all compliance standards through data analysis, and develop tools to enhance the encounter acceptance rate by Medicaid/Medicare. They seek long term improvements in encounter submission processes. They begin to influence the department’s strategy. They make decisions on moderately complex to complex issues regarding technical approach for project components, and their work is done without supervision. They have considerable latitude in determining objectives and approaches to assignments.

Responsibilities

The Senior Encounter Data Management Professional ensures data integrity for claims errors. Their work involves moderately complex to complex issues where the analysis of situations or data requires a deep evaluation of variable factors.

This is a remote position.

#LI

Required Qualifications

• 1+ years of claims processing experience
• 2+ years' experience in analyzing large data sets and providing solutions
• Ability to manage multiple tasks and deadlines with attention to detail
• Proficiency in process mapping, developing procedures and presentations
• Excellent verbal and written communication skills
• Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel 

Preferred Qualifications

• Bachelor's degree in Business, Finance, Accounting, Operations or other related fields
• Medicare or Medicaid experience
• Experience or knowledge of X-12
• Six Sigma Certification 

Additional Information

Work-At-Home Requirements:

• Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors living and working from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mbps download x 10mbps upload) is required. 
• Satellite and Wireless Internet service is NOT permitted for this role.
• A dedicated space free from ongoing interruptions to protect member PHI / HIPAA information is needed.

Interview Format:

As part of our hiring process for this opportunity, we may be using our interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is most convenient for your schedule.

If you are selected for a first-round interview, you will receive an email invitation to participate in a Modern Hire interview.  In this interview, you will be asked a set of interview questions over your phone and you will provide recorded or text message responses to each question. The interview should take about 15 minutes. Your recorded interview will be reviewed, and you will then be informed if you will be moving forward to the next round of interviews.

Social Security Task:

Alert: Humana prioritizes personal identity protection.  Please note that applicants being considered for an interview will be asked to provide their social security number, if it is not already on file.  When required, an email will be sent from with instructions to enter the information into the application at Humana’s secure website.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographical location and individual pay decisions will be determined based on job-related skills, knowledge, experience, education, certifications, etc.

 

$69,800 - $96,200 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based on company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support the whole-person well-being. Associate benefits are designed to promote personal wellness and make smart healthcare decisions for both you and your family, while recognizing that your life extends outside of work. Among our benefits, Humana provides medical, dental, and vision benefits, a 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance, and a range of other opportunities.