Manager, Encounter Data Management
Humana
full-time
Posted on:
Location Type: Remote
Location: Kentucky • United States
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Salary
💰 $86,300 - $118,700 per year
About the role
- 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
- Develops tools to enhance the encounter acceptance rate by Medicaid/Medicare
- Looks for long-term improvements of encounter submission processes
- Makes decisions on resources, approach, and operations of day-to-day focus
- Leads a team of associates who develop efficient business processes for Error Corrections
- Ensures successful submission and reconciliation of encounter submissions across multiple Medicare/Medicaid trading partners
- Plays a key role in influencing departmental strategy
Requirements
- Bachelor's degree in Business, Finance, Operations or other related fields or 3+ years with Medicare and/or Medicaid claims processing or auditing experience
- 2+ years of leadership, coaching and/or team leadership experience
- Demonstrated problems solving skills; ability to give direction and make sound business decisions
- Ability to develop and present information to senior leadership
- Excellent communication skills
- Experience with analyzing and visualizing large data sets
- Ability to manage multiple tasks and deadlines with attention to detail
- Prior experience in a fast-paced insurance or health care setting
- Self-starter, ability to work independently
- Ability to manage multiple priorities simultaneously
- Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Intermediate Excel skills
Benefits
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medicare claims processingMedicaid claims processingdata analysisdata visualizationbusiness process developmenterror correctioncompliance standardsMicrosoft OfficeExcel
Soft Skills
leadershipcoachingproblem solvingcommunicationattention to detailindependencetime managementdecision making
Certifications
Bachelor's degree