Company name
Humana Inc.
Location
Albuquerque, NM, United States
Employment Type
Full-Time
Industry
Finance
Posted on
Apr 08, 2021
Profile
Description
The Medical/Financial Risk Evaluation Professional 2 is responsible for supporting the development, implementation and monitoring of medical/financial risk, and mitigates any medical or financial risk that arises from inadequate or failed processes, people, systems, or external events. In this position, you will work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Responsibilities
Job Description
The hours are Mon-Fri providing coverage 6am-6pm EST with 8 hour flexible shifts to be determined.
Required Qualifications
Current Coding Certification with AAPC or AHIMA
Basic knowledge of CAS/MTV
Data analysis using Excel
Experience creating and presenting information to diverse audiences including senior leaders
Comfortable working in self-directed self-motivated environment
Work at Home/Remote Requirements
Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite, wireless and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required
Preferred Qualifications
Background or knowledge of code edit processes - strongly preferred
Bachelor's degree or 5 years of Health Plan experience
Minimum 3 years experience with claims process **or correct coding
Demonstrated process development experience
Experience implementing claims payment edits or audits
Experience with relational databases (access or SQL) * optional
Adaptable to change
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com