Supervisor, Encounter Data Management

Descripción del puesto:

Become a part of our caring community

The Supervisor, Encounter Data Management 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, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Decisions are typically are related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.

The Supervisor, Encounter Data Management ensures data integrity for claims errors. The Supervisor, Encounter Data Management works within thorough, prescribed guidelines and procedures. You will use, requiring analysis of variable factors to solve basic problems. Additionally, the Supervisor collaborates with management and top professionals/specialists in the selection of methods, techniques, approach. You will report to the Manager, Encounter Data Management.

Performance
* And deadlines with attention to detail
* Demonstrated; ability to give direction and.
* Proven and ability to collaborate with multiple departments
* Deliver presentations to senior leadership

Use your skills to make an impact

Required Qualifications
* 2+ years Medicare and/or Medicaid claims processing experience
* Internal and external error claim processing
* 2+ years of formal or informal leadership experience
* 1+ years' experience working in CAS, Edifecs, Optum and similar DOS 835/837 warehouse systems
* 2 years+ of advanced Microsoft Excel (VLOOKUP, Pivot Tables and ability to create macros)
* 1 year+ SQL experience (running queries)

Preferred Qualifications
* Bachelor's Degree.
* 1+ years' experience in encounter submissions background.
* Certification in Six Sigma or Project Management
* Prior Experience in healthcare or insurance setting
Additional Information

Work-At-Home Requirements
* WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
* A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
* Satellite and Wireless Internet service is NOT allowed for this role.
* A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, 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 pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours
40

Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$65,000 - $88,600 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

Application Deadline: 06-05-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment