Remote TRICARE Claims & Policy Specialist

Humana; Dover (DE); Remoto; USD 54.000 - 73.000; Tempo pieno

Vantaggi offerti da questo lavoro

Remote work

Training opportunities

Travel for occasional meetings

Descrizione del lavoro

Humana, Inc. is seeking a Claims Process and Policy Professional to handle inquiries from beneficiaries, providers, vendors, and internal partners. You will research TRICARE rules, adapt to an integrated environment, and become a SME through knowledge expansion.

The role emphasizes root-cause analysis, data-driven improvement opportunities, and collaboration with teammates. Remote work is supported, with travel for training or meetings as needed.

Competenze

• 3+ years of TRICARE contract experience with claims processing, provider research or administering the benefit.
• 3+ years of experience analyzing data for reports.
• Experience providing clear and concise written responses to customer inquiries.
• Excellent communication and presentation skills for senior/executive leadership.
• U.S. citizenship is required for this Department of Defense contract.
• Ability to obtain government security clearance NBIS.
• HGB is not authorized to work in Puerto Rico under this contract.

Mansioni

• Identify root causes through established intake processes and perform claims research to assess impact.
• Assist peers on root-cause identification and complex issues; participate in required training.
• Maintain integrity, meet deadlines, and take responsibility for actions.

Descrizione del lavoro

Humana, Inc. is seeking a Claims Process and Policy Professional to handle inquiries from beneficiaries, providers, vendors, and internal partners. You will research TRICARE rules, adapt to an integrated environment, and become a SME through knowledge expansion.

The role emphasizes root-cause analysis, data-driven improvement opportunities, and collaboration with teammates. Remote work is supported, with travel for training or meetings as needed.