Payment Integrity Professional - Louisville KY

Profile

Description

Do you have a strong attention to detail with experience in claims or analyzing data reports? Humana is looking for a Payment Integrity Professional to contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment. The Payment Integrity Professional will facilitate and manage department wide projects and initiatives, and will partner with leadership and subject matter experts across the organization to implement process improvements.

Responsibilities

Required Qualifications

• High school diploma or equivalent• A minimum of 3 years of either claims experience or experience analyzing data reports• Working knowledge of Microsoft Office Program Word & PowerPoint• Must have advanced Excel experience with the ability to do formulas, vlookups, pivots & merge data • Strong attention to detail• Can work independently and determine appropriate courses of action• Ability to handle multiple priorities• Capacity to maintain confidentiality• Excellent communication skills both written and verbal

Preferred Qualifications

• 1-5 years' work experience reading and interpreting claims• Experience leading people/projects• Experience in Financial Recovery • Experience using the following systems: CAS, MTV, CISpro and CIS• Knowledge of Microsoft Office Programs Access and Project• Experience in a fast paced, metric driven operational setting

• Experience in leading meetings with a diverse audience• Bilingual in Spanish and English

In order to comply with CDC guidelines, this position will be temporarily a work at home role that will transition back to the office once restrictions are lifted. In order to work at home, the following requirements must be met:

Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work.

Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.

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Company info

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