Job Description
Become a part of our caring community and help us put health first
The Provider Connectivity Professional 2 provides analysis and support to both internal and external customers on complex EDI-related issues (i.e., electronic exchange of data including enrollment, claims, payments, and clearinghouse activities). The Provider Connectivity Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Provider Connectivity Professional 2 responds to complex inquiries relating to EDI from providers and internal departments. May help customers with modem set-up, connection protocols, etc. 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. Use your skills to make an impact
Required Qualifications - 3+ years of medical claims experience processing claims or X12 835 data knowledge
- Minimum of 1 year experience building ad-hoc reports in Excel, Access, or a similar tool
- Strong computer skills including MS Office applications (Word, Excel, PowerPoint)
- Ability to identify trends, communicate results, and make recommendations
- Demonstrated verbal and written communication skills
- Flexible and ability to adapt to change to support ongoing business needs
- Excellent interpersonal, organizational and teamwork skills
Preferred Qualifications - Strong knowledge of SQL
- Experience with Availity BI
- Experience in HIPAA X12 transactions; Claims Submission, Claims Status, Eligibility & Benefits and Referrals & Authorization
- SharePoint knowledge
- Knowledge of provider office processes and experience working in the provider space
Additional Information Humana Perks: Full time associates enjoy: Medical, Dental, Vision and a variety of other supplemental insurances Paid time off (PTO) & Paid Holidays 401(k) retirement savings plan with a competitive match Tuition reimbursement and/or scholarships for qualifying dependent children And much more! Social Security Task: Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website. Virtual Pre-Screen: As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a Modern Hire interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes. Scheduled Weekly Hours 40 Pay Range The 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. $52,500 - $72,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, 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.
About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.
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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
Job Tags
Weekly pay, Holiday work, Full time, Temporary work, Apprenticeship, Remote job, Flexible hours,