TRICARE Claims & Policy Specialist (Remote)

Humana; Bismarck (ND); Remote; USD 54,000 - 73,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Job summary

Humana, Inc. is seeking a Claims Process and Policy Professional 1 for a remote role handling TRICARE claims, policy inquiries, and provider research.

You will research for accuracy and adapt to an integrated work environment to provide precise responses to beneficiaries and partners. Required: 3+ years TRICARE experience, data analysis, clear written communication, US citizenship, and NBIS clearance eligibility.

Qualifications

• 3+ years of TRICARE contract experience in claims processing or related research.
• 3+ years of data analysis for reports.
• Ability to provide clear and concise written responses to customer inquiries.
• Excellent communication and presentation skills for senior/executive leadership.
• U.S. citizenship required for Department of Defense contract.
• Successful NBIS security clearance.
• Not authorized to hire candidates living in Puerto Rico due to contract.

Responsibilities

• Identify root causes and research claims to determine impact.
• Assist peers and SMEs on complex issues and attend training.
• Model integrity, meet deadlines, and take responsibility for actions.

Skills

TRICARE claims processing

Data analysis

Written communication

Executive communication

SQL

US citizenship

NBIS clearance

Education

Bachelor's degree

Tools

SQL

Job description

Humana, Inc. is seeking a Claims Process and Policy Professional 1 for a remote role handling TRICARE claims, policy inquiries, and provider research.

You will research for accuracy and adapt to an integrated work environment to provide precise responses to beneficiaries and partners. Required: 3+ years TRICARE experience, data analysis, clear written communication, US citizenship, and NBIS clearance eligibility.