Encounter Data Management Medicaid Research Professional

** Become a part of our caring community*
* The Encounter Data Management Medicaid Research Professional ensures accurate and compliant Medicare and Medicaid encounter submissions. You will use data analysis and process improvement techniques to increase submission acceptance rates and operational efficiency. Work independently on routine to moderately complex issues and support departmental goals through process improvement.

The Encounter Data Management Medicaid Research Professional supports encounter data integrity by managing claims and encounter data errors. You will work independently to identify issues, recommend solutions, and ensure compliance with Medicaid data submission requirements. Assignments are varied and require. You will report to the Senior Encounter Data Management Professional and be a part of the Encounters Submissions team.

** Use your skills to make an impact*
* + Manage and analyze large datasets related to Medicaid claims and encounter data to identify trends and patterns.

+ Maintain data quality control processes to ensure accuracy and completeness of data.

+ Collaborate with teams to design and implement data management solutions.

+ Conduct data validation and quality assurance activities to ensure data integrity.

+ Develop and maintain documentation of data management processes.

+ Demonstrated attention to detail, consistently meeting established quality standards

** Use your skills to make an impact*
* ** Required Qualifications*
* +  
** 1+ year of experience in medical claims adjudication, claims auditing, or encounter submissions.*
* +  
** Ability to accurately resolve claims issues and meet established deadlines.*
* +  
** 1+ year of experience conducting root cause analysis and implementing resolutions.*
* +  
** 1+ year of experience documenting processes, procedures, and findings accurately and thoroughly.*
* ** Preferred Qualifications*
* ** Bachelor's degree in business, Finance, Accounting, Operations or other related fields*
* ** Experience identifying, researching, and resolving Medicaid claims and encounter data errors*
* ** Prior health insurance industry experience*
* ** Working knowledge of Microsoft SQL or SAS*
* ** 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 Hire Vue, 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.

Work at Home Requirements To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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