TRICARE Claims & Policy Specialist - Remote

Humana; Boise (ID); Remote; USD 54,000 - 73,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement plan

Paid time off

Job summary

Humana, Inc. is seeking a Claims Process and Policy Professional 1 in a remote role to research TRICARE claims, answer inquiries, and support root cause analysis with providers, beneficiaries, and internal teams.

Ideal candidates have 3+ years in TRICARE, data analysis skills, and strong written and verbal communication for senior leadership. U.S. citizenship and NBIS clearance are required; occasional travel may be expected.

Qualifications

• 3+ years of TRICARE claims processing or provider research experience.
• Experience analyzing data for reports.
• Clear and concise written responses to customer inquiries.
• Excellent communication to senior/executive leadership.

Responsibilities

• Identify root causes from intake processes to resolve issues.
• Conduct claims research to assess impact on reported issues.
• Identify opportunities for process improvements.
• Become a TRICARE claims SME.
• Meet established expectations and drive results.
• Support peers on complex issues and root-cause analysis.

Skills

TRICARE claims processing

Data analysis

Written responses to inquiries

Communication to executive leadership

U.S. citizenship

Education

Bachelor's degree

Tools

SQL

Job description

Humana, Inc. is seeking a Claims Process and Policy Professional 1 in a remote role to research TRICARE claims, answer inquiries, and support root cause analysis with providers, beneficiaries, and internal teams.

Ideal candidates have 3+ years in TRICARE, data analysis skills, and strong written and verbal communication for senior leadership. U.S. citizenship and NBIS clearance are required; occasional travel may be expected.