Encounter Data Management Professional 2
Remote US
The Encounter Data Management Professional 2 develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission and response processes. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.The Encounter Data Management Professional 2 ensures data integrity for claims errors. The Encounter Data Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Use your skills to make an impact
Required Qualifications
- Bachelor's degree or 3+ years related experience
- Prior data reporting experience
- Strong analysis, critical thinking, and analytical problem-solving skills
- Ability to manage multiple tasks and deadlines with attention to detail
- Excellent communication skills
- Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- Master's degree in business administration or a related field
- Prior health insurance industry experience
- Working knowledge of Microsoft SQL/PLSQL
Scheduled Weekly Hours
40Pay 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 geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 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 many other opportunities.About us
About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
ApplyJob Profile
Remote US
Benefits/Perks401(k) 401k retirement 401k Retirement Savings Bonus Incentive Bonus incentive plan Caring community Coaching Competitive benefits Dental Dental benefits Disability Flexible scheduling Health insurance Health outcomes Holidays Life Life Insurance Long Term Disability Medical Medical benefits Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Short Term Disability Smart healthcare decisions Support whole-person well-being Time off Vision Vision Benefits Volunteer time Volunteer time off
Tasks- Analysis
- Coaching
- Communication
- Compliance
- Data Integrity Management
- Data Management
- Develop business processes
- Enhance encounter acceptance rate
- Ensure compliance standards
- Improve health outcomes
- Interpretation
- Manage multiple tasks
- Reporting
- Training
Analysis Analytical Analytical Problem Solving Attention to detail Business Business administration Claims Clinical Coaching Communication Compensation Compliance Compliance Standards Consumer Experiences Critical thinking Data Data analysis Data integrity Data Management Data Reporting Dental Excel Healthcare Health Insurance Health Services Home Health Home health services Insurance Leadership Leadership Development Life Insurance Management Medicaid Medicare Medication Adherence Microsoft Microsoft Office Microsoft Office Applications Microsoft SQL Organization Organizational Outlook Pharmacy PL/SQL Policy PowerPoint Problem-solving Recruitment Reporting SAFe Scheduling SQL Strategy Training Vision Wellness Word
Experience3 years
EducationAssociate Bachelor's Bachelor's degree Business Business Administration Communication Education Healthcare Health Outcomes Health Services Higher IT Management Master's Master's degree Master's degree in Business Master's Degree in Business Administration Related Field
Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9