97 applicants

Company

Humana · 10 hours ago

Physician Reimbursement Senior Analysis Professional

Remote Nationwide

Full-time

Remote

Mid, Senior Level

$89K/yr - $121K/yr

2+ years exp

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Responsibilities

Ensure timely and accurate Physician reimbursement.

Interpret reimbursement language and initiatives (contracts, legislation, etc.).

Understand provider payment methodologies and policies.

Decipher, integrate, troubleshoot and help build out how reimbursement works in our systems.

Work with large datasets and transform data.

Collaborate with IT and dev resources to maintain data in systems.

Build out reimbursement terms within Humana systems.

Understand the relationship between systems and implement complex builds.

Research and troubleshoot existing systematic pricing mechanisms.

Help implement new pricing mechanisms.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Interpreting provider contractsClaims research experienceData analysisMicrosoft ExcelMicrosoft AccessWorking with large datasetsSQLProject managementSharePoint maintenanceData dashboard solutions

Required

2 or more years of Experience in interpreting provider contracts and reimbursement legislation policy or related area.

3 or more years of Claims research experience or related area (reporting and individual claim views).

Advanced knowledge of Microsoft Office Applications, especially Excel and Access

Experience working with big and complex data sets (flat files, 1mil+ records)

Experience analyzing data to solve a wide variety of business problems (finding root cause to trending claims issues, etc.)

Preferred

Bachelors Degree

Experience with project management and/or managing process automations

Intermediate experience in SQL, and other data systems

Experience maintaining SharePoint and/or data dashboard solutions (MS Access, Power BI)

Benefits

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

Company

Humana

Glassdoor

3.8

Humana is a health insurance provider for individuals, families, and businesses.

Founded in 1964

Louisville, Kentucky, USA

10001+ employees

http://www.humana.com

H1B Sponsorship

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Distribution of Different Job Fields Receiving Sponsorship

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Trends of Total Sponsorships

2023 (217)

2022 (257)

2021 (258)

2020 (107)