Provider Connectivity Professional

Become a part of our caring community and help us put health first
 The Provider Connectivity Professional 2 provides analysis and support to both internal and external customers on complex Electronic Data Interchange (EDI)-related issues (i.e., electronic exchange of data including authorizations/referrals, eligibility and benefits, electronic attachments and clearinghouse activities). The Provider Connectivity Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Provider Connectivity Professional 2 responds to complex inquiries relating to EDI from providers, vendors and internal departments. 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.

Use your skills to make an impact
 

Required Qualifications

• Minimum of an Associate’s degree

• Strong knowledge of Microsoft products to include Excel, Outlook, Word, Teams and/or PowerPoint

• Experience working with EDI (Electronic Data Interchange) systems

• Experience building reports (For example in Excel, Power B.I. or data software tools)

• Ability to work independently and in a self-guided/driven environment

• Ability to identify trends, communicate results, and make recommendations

• Excellent communication skills, both written and verbal

• Flexible and with the ability to adapt to change to support ongoing business needs

Preferred Qualifications

• Experience in HIPAA X12 transactions; Eligibility & Benefits and Referrals, SharePoint knowledge

• Experience working with healthcare related data (Insurance, Clinical, Provider, Managed care etc…)

• Strong knowledge of SQL, Access & Visio

• Knowledge of provider office processes and experience working in the provider space

• Experience building reports in SSRS, Tableau, Power BI or a similar tool

• Experience with querying and extracting data from different data sources to include EDW, SQL, and Access databases

Additional Information

Work Style: Remote

HireVue Statement:  As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work at Home/Remote Requirements 
To ensure Hybrid Office/Home associates’ ability to work effectively, the self-provided internet service of Hybrid Office/Home associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office associates with telephone and computer equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

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 geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$52,500 - $72,300 per year

 

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

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
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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.

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