Supervisor, Encounter Data Management

🔥 6 minutes ago

🇺🇸 United States – Remote

💵 $65k - $88.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Develop business processes for successful submission and reconciliation of encounter submissions to Medicaid/Medicare • Ensure encounter submissions meet or exceed compliance standards through data analysis • Develop tools to improve the encounter acceptance rate by Medicaid/Medicare • Identify long-term improvements to encounter submission processes • Make decisions related to schedules, plans and daily operations • Handle escalated and complex issues • Supervise support and technical associates • Provide day-to-day guidance and oversight • Ensure consistency in execution across the team • Hold team members accountable for established policies • Give direction and guidance • Collaborate with multiple departments • Deliver presentations to senior leadership • Report to the Manager, Encounter Data Management

🎯 Requirements

• 2+ years Medicare and/or Medicaid claims processing experience • Experience with 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, including VLOOKUP, Pivot Tables and ability to create macros • 1 year+ SQL experience running queries • Bachelor's Degree preferred • 1+ years' experience in encounter submissions background preferred • Certification in Six Sigma or Project Management preferred • Prior experience in healthcare or insurance setting preferred • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Dedicated work space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Whole-person well-being and personal wellness support • Occasional travel to Humana offices for training or meetings