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Senior Encounter Data Management Professional
Senior Encounter Data Management Professional-August 2024
Flexible / Remote
Aug 26, 2026
ABOUT HUMANA
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized whole-person healthcare experiences.
10,000+ employees
Healthcare
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About Senior Encounter Data Management Professional

  Become a part of our caring community and help us put health first

  

  The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via pulling and analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

  The Senior Encounter Data Management Professional ensures data integrity for claims errors. This would be accomplished by doing end to end analysis of encounter submissions to identify new data and methods for long term resolution. The Senior Encounter Data Management Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role will include data pulling, data analysis, requirements review and creation, data validation.

  This is a remote position

  #LI-Remote

  

  Use your skills to make an impact

  

  Required Qualifications

  3+ years of requirements writing or UAT validations3+ years of SQL data pulling and data analysis3+ years of claims/encounter processingPrior experience in a fast-paced insurance or health care settingAbility to manage multiple tasks and deadlines with attention to detailComprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel

  Preferred Qualifications

  Bachelor's degree in Business, Finance, Operations or other related fieldsCAS or MTV experienceX12 ExperiencePrior demonstrated experience with project managementPrior experience with Medicare and Medicaid programsSix Sigma certification a plus

  Additional Information

  Why Humana? You'll experience the following perks as a full-time Humana employee:

  Compensation and Financial Security - Our pay philosophy is designed to motivate and reward associates for their skills and contributions to the company. We provide options to help you plan for your future and protect your assets: Competitive base pay, Recognition pay, 401(k) retirement savings plan (125% match for the first 6% contributed by an associate), etc.

  Your Whole Health - Humana's health products and services are designed to encourage personal wellness and smart healthcare decisions for you and your family: Medical, dental, and vision benefits, Health plan incentives, Paternity leave, etc.

  Work Perks - Humana knows your life extends outside of work. We have many options to support your interests and needs. Some departments have the flexibility to allow associates to work from home, and we offer all associates: Paid time off, holidays, volunteer time, jury duty pay, Associate charity matching program, Discount programs with major retailers, etc.

  Grow With Us - Humana provides growth and career opportunities that can help you develop your skills and build your future with the organization: Internal and external learning events, Tuition assistance, Inclusion and diversity training, etc.

  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 [email protected] with instructions to add the information into the application at Humana's secure website.

  Interview Format:

  As part of our hiring process for this opportunity, you may be utilizing our interviewing 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 first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will receive a set of interview questions over your phone and you will provide recorded or text message responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

  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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

  $69,800 - $96,200 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 because he or she is a protected veteran. 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.

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