Health Information Management P2 - Provider Education and Research

Profile

Description

The Health Information Management Professional 2 ensures data integrity for claim errors while focusing on provider education and ongoing research. The Health Information Management Professional 2 work assignments are varied and frequently require research, interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Health Information 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 research, analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Collaborates with external teams to provide education. Owns Provider Education process and maintains provider education tracker. Looks for opportunity to communicate fixes with Provider Outreach and Market teams. Manages special projects with the ability to operate under tight deadlines. Communicates insight and analytical findings in professional manner. Prepare presentations for different leaders across business. 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.

Required Qualifications


Strong critical thinking and analytical problem solving skills
Ability to manage multiple tasks and deadlines with attention to detail
Proven communication and conflict resolution
Prior claims experience
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
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
Must ensure designated work area is free from distractions during work hours and virtual meetingsMust provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required


Preferred Qualifications


Bachelor's degree in Business, Finance, Accounting, Operations or other related fields, or equivalent to 5 years business experience
Prior health insurance industry experience
Prior X12 experience
Working knowledge of Microsoft SQL or SAS
Prior CAS experience


Additional Information

This position will be located at the Humana Waterfront facility in Louisville, Kentucky but will temporarily be working remote.

Scheduled Weekly Hours

40

Company info

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