Encounter Submissions Reporting Professional 2

Profile

Description

The Health Information Management Professional 2 ensures data integrity for claims errors. The Health Information Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Encounter Submissions Reporting Professional 2 develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicare. Looks for long term improvements of encounter submission processes. 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.

Required Qualifications

1 - 5 years of reporting and data analysis

1 years of SQL experience - must be able to create queries, sub queries, common table expressions, temp tables, joins and unions

Ability to manage multiple tasks and deadlines with attention to detail

Excellent communication skills: communicate findings and impacts in a clear and professional manner

Utilize out of the box thinking to come up with new solutions. Utilize critical thinking to prioritize the problems and determine feasibility of resolving or preventing in the future.

Innovate and look for a better way of creating and monitoring trends with CMS and Medicaid submission data

1 years Microsoft Excel reporting, graphs, pivot table experience

Preferred Qualifications

Bachelor's degree

Process Improvement experience

Power BI experience or other dashboard experience

PLSQL/Netezza knowledge

EDW knowledge

Working knowledge of CAS, Medicare Products, MRA submission system, X-12 format

Present and communicate with leadership reports and other findings of analysis reports

Microsoft Word and PowerPoint

Additional Information

Associates are required to be fully COVID vaccinated, including booster, 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.If progressed to offer, candidates will be required to:

Provide proof of full vaccination, including booster OR

Provide proof of applicable exemption including any required supporting documentation

Medical, religious, and state exemptions will be available.

Scheduled Weekly Hours

40

Company info

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