Remote TRICARE Claims and Policy Specialist

Humana; Phoenix (AZ); Remoto; USD 5300 - 73.000; Tempo pieno

Vantaggi offerti da questo lavoro

Remote work

Travel for training

Descrizione del lavoro

Humana, Inc. is seeking a Claims Process and Policy Professional 1 for a remote role focused on researching TRICARE rules and delivering accurate responses to inquiries from beneficiaries, providers, and partners. You will develop SME knowledge, identify root causes, and drive process improvements.

The role emphasizes clear written communication, strong data analysis, and collaboration with peers and leadership. Occasional travel to Humana offices may be required for training or meetings.

Competenze

• 3+ years of TRICARE contract experience in claims processing or related benefits.
• 2+ years of data analysis experience for reports.
• Ability to provide clear, concise written responses to inquiries.
• Excellent communication and presentation skills for senior leadership.
• U.S. citizenship is required for this Department of Defense contract.
• Successful NBIS government security clearance approval.
• Not authorized to hire in Puerto Rico under this contract.

Mansioni

• Identify root causes through the intake process and document findings.
• Perform claims research to assess impact on reported issues.
• Spot opportunities for process improvements based on analysis.
• Develop SME-level expertise in TRICARE claims processing.
• Meet established expectations and deliver results.
• Assist peers on complex issues and participate in required trainings.
• Stay informed on how TRICARE reimbursements affect daily work.
• Model integrity and reliability, meet commitments.

Conoscenze

TRICARE claims processing

Data analysis for reports

Clear written responses

Communication and presentation skills

US citizenship

NBIS clearance

Remote work with security requirements

Formazione

Bachelor's degree

Strumenti

SQL

Descrizione del lavoro

Humana, Inc. is seeking a Claims Process and Policy Professional 1 for a remote role focused on researching TRICARE rules and delivering accurate responses to inquiries from beneficiaries, providers, and partners. You will develop SME knowledge, identify root causes, and drive process improvements.

The role emphasizes clear written communication, strong data analysis, and collaboration with peers and leadership. Occasional travel to Humana offices may be required for training or meetings.