Risk Adjustment Admin Professional

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $59.3k - $80.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🎲 Risk

🚫👨‍🎓 No degree required

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Upload audit packets for CMS RADV (Risk Adjustment Data Validation) to CDAT (Central Data Abstraction Tool) • Conduct administrative review and claims review/investigation • Analyze data uploaded to CMS • Review packets • Verify member data matches prior to upload • Work closely with the retrieval team and other internal groups • Prioritize and complete work driven by CMS deadlines • Support team members after completing assigned work and request additional work when needed

🎯 Requirements

• 2+ years of Microsoft Excel experience • Software/applications navigation skills • Experience cross-validating data sets • Ability to verify member data matches prior to upload • Preferred: CAS claims experience reviewing and understanding • Ability to prioritize tasks to meet internal and external deadlines • Task-oriented and able to complete and prioritize assigned work • Self-motivated and able to work with minimal supervision • Team-oriented and willing to help team members and request additional work • Minimum home internet speed of 25 Mbps download and 10 Mbps upload for home or hybrid home/office employees • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Remote work arrangement • Flexible/self-provided home working arrangement