Humana

Encounter Data Management Professional

Humana

Louisville, KY, USA
Full-TimeDepends on ExperienceSenior LevelMasters
Job Description

Are you a detail-oriented and data-driven professional looking to make a positive impact on the healthcare industry? Humana is seeking an experienced Encounter Data Management Professional to join our team and help us effectively manage and analyze healthcare data. If you have a passion for data management, strong analytical skills, and a desire to contribute to the improvement of healthcare delivery, we want to hear from you! This is an exciting opportunity to be a part of a dynamic and innovative organization that is dedicated to improving the lives of our members. Join us and make a difference in the world of encounter data management.

  1. Manage healthcare data: The primary responsibility of this role is to effectively manage and analyze healthcare data, specifically encounter data.
  2. Ensure accuracy and completeness: The Encounter Data Management Professional will be responsible for ensuring the accuracy and completeness of encounter data through regular audits and data validation processes.
  3. Identify and resolve data discrepancies: This individual will be expected to identify and resolve any discrepancies or errors in encounter data, working closely with other team members and departments to ensure data integrity.
  4. Analyze data and provide insights: Utilizing strong analytical skills, the Encounter Data Management Professional will analyze encounter data to identify trends, patterns, and opportunities for improvement in healthcare delivery.
  5. Collaborate with cross-functional teams: This role will require working closely with other teams and departments, such as IT, operations, and finance, to ensure data is managed and utilized effectively across the organization.
  6. Develop and implement data management processes: The Encounter Data Management Professional will be responsible for developing and implementing data management processes to ensure the accurate and timely processing of encounter data.
  7. Stay up-to-date on industry trends and regulations: It will be the responsibility of this individual to stay informed on the latest industry trends and regulations related to encounter data management, and to incorporate this knowledge into their work.
  8. Contribute to continuous improvement: The Encounter Data Management Professional will play a key role in identifying opportunities for continuous improvement in data management processes and implementing solutions to enhance data accuracy and efficiency.
  9. Adhere to compliance and regulatory requirements: This role will be responsible for adhering to all compliance and regulatory requirements related to encounter data management, ensuring that all data is handled in accordance with applicable laws and regulations.
  10. Communicate effectively: The Encounter Data Management Professional will be expected to communicate effectively with team members, stakeholders, and external partners to provide updates, share insights, and address any issues related to encounter data management.
  11. Support team goals and objectives: As a member of the encounter data management team, this
Where is this job?
This job is located at Louisville, KY, USA
Job Qualifications
  • Bachelor's Degree In Healthcare Administration, Health Informatics, Or A Related Field.

  • Minimum Of 3 Years Experience In Encounter Data Management Within The Healthcare Industry.

  • Knowledge Of Encounter Data Submission Requirements For Medicare Advantage And/Or Medicaid Managed Care Programs.

  • Proficiency In Encounter Data Processing Software, Such As Edi Validation Tools And Claims Processing Systems.

  • Strong Analytical And Problem-Solving Skills, With The Ability To Identify And Resolve Encounter Data Issues In A Timely Manner.

Required Skills
  • Data Analysis

  • Quality

  • Microsoft Excel

  • Database Management

  • Claims Processing

  • Reporting

  • Coding

  • Compliance

  • Risk Adjustment

  • Medicare Advantage

  • Electronic Health Records (Ehr)

  • Encounter Submissions

Soft Skills
  • Communication

  • Conflict Resolution

  • Leadership

  • Time management

  • Interpersonal Skills

  • creativity

  • Critical thinking

  • Teamwork

  • Adaptability

  • Problem-Solving

Compensation

According to JobzMall, the average salary range for a Encounter Data Management Professional in Louisville, KY, USA is between $60,000 to $80,000 per year. This range can vary depending on factors such as experience, education, and specific job duties.

Additional Information
Humana is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedApril 11th, 2024
Apply BeforeMay 22nd, 2025
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About Humana

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.

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