Become a part of our caring community and help us put health first
 

The Senior Encounter Data Management Professional 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 processes. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. The position will be responsible for trading partner analysis and error prevention.

The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior Encounter Data Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The position will be responsible for both Medicare and Medicaid trading partner analysis and error prevention, with increased Medicaid focus.

Use your skills to make an impact
 

Required Qualifications

• 3 years claims processing background and/or experience with encounter submissions
• Bachelor’s degree and/or 5 years or more related experience
• Shown success leading/influencing projects
• Ability to manage multiple tasks and deadlines with attention to detail and minimal direction
• Excellent communication skills
• Self-starter, ability to work independently
• Ability to manage multiple priorities simultaneously
• Excellent collaboration skills
• Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel

Preferred Qualifications

• Prior demonstrated experience with project management
• Prior experience with Medicare and Medicaid programs
• Prior experience in a fast-paced insurance or health care setting

Additional Information

Note: This position is onsite as needed.

Work-At-Home Requirements:

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

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

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.

 

$69,800 - $96,200 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 (collect