Humana
Responsibilities
This position requires an 18 month commitment.
The Business Intelligence Engineer 2 updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. 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 Experience in Provider Reimbursement/ Contract Load
- 1 or more years of technical experience (ability to learn and navigate new systems quickly and proficiently)
- 1 or more years customer service
- Demonstrated analytical skills with proven ability analyzing data and identifying trends
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- Experience in claims or billing and enrollment
- Provider contract experience
- Knowledge of reimbursement policies
Additional Information
- Work at Home/Remote Requirements
- Must ensure designated work area is free from distractions during work hours and virtual meetings
- Must provide a high-speed DSL or cable modem for a workspace (Satellite, wireless and Hotspots are prohibited). A minimum standard speed of 10×1 (10mbs download x 1mbs upload) for optimal performance of is required
Scheduled Weekly Hours
40
To apply for this job please visit humana.wd5.myworkdayjobs.com.