Supervisor, Encounter Data Management

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

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 develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Decisions are typically are related to schedule, plans and daily operations.

Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.

The Supervisor, Encounter Data Management ensures data integrity for claims errors. The Supervisor, Encounter Data Management works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach. This position will report to the Encounter Data Management, Manager.

• 4 + years of claims experience
• Understanding of Medicaid and Medicare processes, including 835/820 transactions
• 2+ years of experience leading or supervising a team or large‑scale projects.
• Proven ability to manage large data and transaction volumes and determine priority order of work
• Ability to multitask and work under tight deadlines with strong attention to detail
• Demonstrated experience with process improvements
• Effective communicator with strong presentation and documentation skills
• Demonstrated problems solving skills; ability to give direction and make sound business decisions
• Proven organizational and prioritization skills and ability to collaborate with multiple departments
• Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel

• Bachelor's degree
• CAS experience
• Certification in Six Sigma or Project Management
• Prior Experience in healthcare or insurance setting

• 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

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue to enhance our hiring and decision-making ability. Hire Vue 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, you will receive correspondence inviting you to participate in a Hire Vue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 15 - 20 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round.

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

40

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.

$65,000 - $88,600 per year

This job is eligible for a bonus incentive plan.…