Provider Connectivity Professional 2 – Remote USA – Humana
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Humana (501+ Employees, 13% 2 Yr Employee Growth Rate)
4% 1-Year Employee Growth Rate | 13% 2-Year Employee Growth Rate | LinkedIn | $750M Venture Funding
What Is Employee Growth Rate & Why Is It Important?
Description
The Provider Connectivity Professional 2 provides analysis and support to both internal and external customers on complex EDI-related issues (i.e., electronic exchange of data including authorizations/referrals, eligibility and benefits, electronic attachments and clearinghouse activities). The Provider Connectivity Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Responsibilities
The Provider Connectivity Professional 2 responds to complex inquiries relating to EDI from providers, vendors and internal departments. 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 equivalent combination of education and experience
- Strong knowledge of Microsoft products Excel, Access, PowerPoint, Visio
- 2 or more years of experience building reports in SSRS or a similar tool
- 1 or more years of experience with querying and extracting data from different data sources to include EDW, SQL, and Access databases
- Ability to identify trends, communicate results, and make recommendations
- Excellent organizational skills
- Demonstrated verbal and written communication skills
- Flexible and ability to adapt to change to support ongoing business needs
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- Strong knowledge of SQL
- Experience with Availity BI
- Experience in HIPAA X12 transactions; Claims Submission, Claims Status, Eligibility & Benefits and Referrals & Authorization
- SharePoint knowledge
- Knowledge of provider office processes and experience working in the provider space
Additional Information
Remote/Work at Home Requirements
Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
- A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
- Satellite and Wireless Internet service is NOT allowed for this role.
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Scheduled Weekly Hours
40