Remote TRICARE Claims & Policy Specialist

Humana, Inc.; Cheyenne (WY); Remoto; USD 54.000 - 73.000; Tempo pieno

Descrizione del lavoro

Humana, Inc. is seeking a Claims Process and Policy Professional 1 for a remote role in the United States. You will handle TRICARE-related claims inquiries, research to ensure accuracy, and work with teams to provide complete responses while upholding security requirements.

The position emphasizes root-cause analysis, claims SME development, and ongoing learning, with travel occasional for training or meetings. 40 hours/week remote work is expected.

Competenze

• 3+ years experience with TRICARE claims processing
• 3+ years experience analyzing data for reports
• Experience providing clear written responses to customer inquiries
• Excellent communication and presentation skills for senior leadership
• US citizenship is required for this position
• Security clearance NBIS approval required
• HGB not authorized to work in Puerto Rico under government contract

Mansioni

• Identify root causes through established intake process.
• Research claims to determine impact on reported issues.
• Identify opportunities for improvement based on analysis.
• Grow to become a claims SME and share knowledge.
• Meet deadlines and deliver results.
• Assist peers on complex issues and participate in required trainings.

Conoscenze

TRICARE claims processing

Data analysis

Customer inquiries responses

Executive communication

Security clearance NBIS

Formazione

Bachelor's degree

Strumenti

SQL

Descrizione del lavoro

Humana, Inc. is seeking a Claims Process and Policy Professional 1 for a remote role in the United States. You will handle TRICARE-related claims inquiries, research to ensure accuracy, and work with teams to provide complete responses while upholding security requirements.

The position emphasizes root-cause analysis, claims SME development, and ongoing learning, with travel occasional for training or meetings. 40 hours/week remote work is expected.