Supervisor, Encounter Data Management

Humana

3d • $65,000 - $88,600 • Remote

About The Position

The Supervisor, Encounter Data Management 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 analysis of data, and develop tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Makes decisions related to schedules, plans, and daily operations. Handles escalated and complex issues, supervises a team of support and technical associates, and provides day-to-day guidance and oversight. Ensures consistency in execution across team. Holds team members accountable for following established policies.

Requirements

• 2+ years Medicare and/or Medicaid claims processing experience
• 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 (VLOOKUP, Pivot Tables and ability to create macros)
• 1 year+ SQL experience (running queries)
• Demonstrated ability to give direction and guidance
• Proven ability to collaborate with multiple departments

Nice To Haves

• Bachelor's Degree.
• 1+ years' experience in encounter submissions background.
• Certification in Six Sigma or Project Management
• Prior Experience in healthcare or insurance setting

Responsibilities

• 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 analysis of data.
• Develops tools to enhance the encounter acceptance rate by Medicaid/Medicare.
• Looks for long term improvements of encounter submission processes.
• Makes decisions related to schedules, plans, and daily operations.
• Handles escalated and complex issues.
• Supervises a team of support and technical associates, and provides day-to-day guidance and oversight.
• Ensures consistency in execution across team.
• Holds team members accountable for following established policies.
• Deliver presentations to senior leadership

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• bonus incentive plan

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree