Humana · 8 hours ago
Physician Reimbursement Senior Analysis Professional
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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
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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
Humana is a health insurance provider for individuals, families, and businesses.
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (217)
2022 (257)
2021 (258)
2020 (107)
Funding
Current Stage
Public CompanyTotal Funding
$6.82B2024-03-11Post Ipo Debt· $2.25B
2023-11-02Post Ipo Debt· $1.32B
2023-02-27Post Ipo Debt· $1.25B
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