Humana

About Humana

 

Job Category:

Consumer Service Operations - Provider Network Operations

Country:

United States

Postal Code:

40201

Approximate Salary:

Not Specified

Position Type:

Full Time

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Senior Provider Connectivity Professional-Louisville, KY

Humana - Louisville, Kentucky

Posted: 09/13/2018

Description

The Senior Provider Connectivity Professional provides analysis and support to both internal and external customers on complex EDI-related issues (i.e., electronic exchange of data including enrollment, claims, payments, and clearinghouse activities). The Senior Provider Connectivity Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Provider Connectivity Professional operates in inquiries relating to EDI from providers and internal departments. As part of Integrated Provider Process Solutions, the professional is important in project implementation, testing, and trouble-shooting responsibilities related to electronic claims submissions.  The Professional will make decisions on moderately complex to complex issues regarding technical approaches for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

               

Required Qualifications    
•    High school diploma or equivalent
•    Prior claims experience
•    Strong Project Management skills
•    Strong computer skills including MS Office applications (Word, Excel,)
•    Demonstrated competency in both oral and written communication skills
•    Solid understanding of process / work flow concepts
•    Excellent interpersonal and teamwork skills
Preferred Qualifications
•    Bachelor’s degree
•    PowerPoint, Visio
•    Excellent knowledge of Medicare and/or Medicaid products
•    CAS knowledge
•    Six Sigma or LEAN certification desired
•    Previous experience with provider facing communication
Additional Information
Interview Format 

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. 
If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 

Scheduled Weekly Hours

40

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