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Health Information Management Professional 2

Company: Humana
Location: Louisville
Posted on: January 16, 2022

Job Description:

**Description** The Health Information Management Professional 2 ensures data integrity for claims errors. The Health Information Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. **Responsibilities** The Health Information Management Professional 2 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. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Required Qualifications** + Bachelor's degree or 3+ years of related worked experience + 1+ years of Medical claims experience (auditing, processing, loading, etc...) + Experience with analyzing and visualizing large data sets and presenting information to leaders + Strong analysis, critical thinking, and analytical problem solving skills + Ability to manage multiple tasks and deadlines with attention to detail + Excellent written and verbal communication skills + Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel + Working knowledge of SQL writing and creating queries (ORACLE, Microsoft SQL Server, Netezza) + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Master's Degree in Business Administration or a related field + 1+ years of X-12 data knowledge + Prior experience in a fast paced insurance or health care setting + Prior experience with Medicare and Medicaid programs + CAS Auditing, Claims Adjudication or other Payer Platform Experience + Sig Sigma certification a plus **Additional Information** **Scheduled Weekly Hours** 40

Keywords: Humana, Louisville , Health Information Management Professional 2, Executive , Louisville, Kentucky

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