Remote TRICARE Claims & Policy Analyst

Humana; Salem (OR); Remote; USD 54.000 - 73.000; Vollzeit

Zusammenfassung

Humana, Inc. is seeking a Claims Process and Policy Professional 1 to handle TRICARE claims and policy inquiries in a remote capacity. You will research, validate, and resolve issues with accuracy, collaborating with a cross-functional team to deliver timely responses.

Responsibilities include root-cause analysis, documentation, and continual learning about the TRICARE program and reimbursement methodologies, while maintaining compliance and quality standards.

Qualifikationen

• 3+ years of experience with TRICARE contract and claims processing.

Aufgaben

• Identify root causes via established intake process.
• Perform claims research to determine impact.
• Identify improvement opportunities based on analysis.
• Become a claims SME through knowledge enhancement.
• Meet established expectations and achieve results.
• Assist peers on complex issues and participate in required training.
• Travel occasionally for training or meetings.

Kenntnisse

TRICARE claims processing

Data analysis

Clear written communication

Communication and presentation to exec

US citizenship

Security clearance NBIS

Ausbildung

Bachelor's degree

Tools

SQL

Jobbeschreibung

Humana, Inc. is seeking a Claims Process and Policy Professional 1 to handle TRICARE claims and policy inquiries in a remote capacity. You will research, validate, and resolve issues with accuracy, collaborating with a cross-functional team to deliver timely responses.

Responsibilities include root-cause analysis, documentation, and continual learning about the TRICARE program and reimbursement methodologies, while maintaining compliance and quality standards.