Database Administrator - Remote Puerto Rico Sign-On Bonus

Profile

Job Information

Humana

Database Administrator - Remote Puerto Rico *Sign-On Bonus*

in

San Juan

Puerto Rico

Description

The Database Administrator selects, implements, and loads the system applications that administer benefit plan provisions, provider demographics, and provider website data. The Plan Build Representative performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

The Database Administrator

Analyzes and maintains required changes for existing health plans driven by market product design, legislative and regulatory needs

Determines required system changes to support new products, services, or efficiencies through design, test, and implementation stages

Daily review of claim pending reports to correct Computer Science Cooperation/CarePlus Health Plans' Internal (CSC) system issues for benefit and provider loads

Internal audit of claims in Health Rules Payer (HRP) system to ensure each claim processes with expected benefit, provider and fee table and contract configuration results

Internal audit of claims, authorizations and processes connected to the Provider Portal to ensure authorization requests, claims data and portal processes (secure messaging) respond with expected results

Working of error reports to ensure provider data integrity

Ensures adherence of compliance and audit processes, and supports system error resolution and remediation

Supports training and development of procedures

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

Hours will be Monday-Friday 8:00am-5:00pm with opportunity for overtime and/or flex scheduling

$1000 Sign-On Bonus ($300 upon hire, balance at completion of contract)

Position will be Limited Term contract of 6 months

Required Qualifications

Proficient computer skills (MS Word, Excel, Outlook, Power Point, MS Access and medical related software)

High technical experience/background

Knowledge of medical terminology, ICD-10 and CPT/HCPC coding

Strong interpersonal and communication skills

Strong organizational skills

Overall knowledge of Medicare standards and regulations

Website experience

Must Reside in Puerto Rico

Preferred Qualifications

Bilingual English/Spanish with ability to pass a language assessment

Associates Degree (AA/AS) and/or equivalent

Experience in Health Maintenance Organization (HMO) claims processing

Additional Information

For this job, associates are required to be fully COVID vaccinated, including booster (preferred) or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination, including booster  or commit to testing protocols OR  

Provide proof of applicable exemption including any required supporting documentation

​​Medical, religious, state and remote-only work exemptions are available.

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, 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 SMS Text Messaging interview. You should anticipate this interview to take approximately 5-10 minutes.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com