TRICARE Claims & Policy Specialist (Remote)

Humana; Olympia (WA); Remoto; USD 54.000 - 73.000; Tempo pieno

Vantaggi offerti da questo lavoro

Remote work

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 claims, perform research, and respond to inquiries from beneficiaries, providers, and partners while advancing to SME status.

Required experience includes TRICARE contract claims processing and data analysis, with strong written and verbal communication. U.S. citizenship and NBIS clearance are required, with rare travel for training or meetings.

Competenze

• 3+ years of experience with TRICARE contract working with claims processing or provider research
• 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 required for DoD contract
• Ability to obtain government security clearance (NBIS)
• Not authorized to hire candidates living in Puerto Rico under government contract

Mansioni

• Identify root causes through established intake process and perform claims research to determine impact
• Identify improvement opportunities based on analysis
• Become a claims SME and meet performance expectations
• Assist peers on complex issues and participate in related training

Conoscenze

Communication skills

Data analysis

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 claims, perform research, and respond to inquiries from beneficiaries, providers, and partners while advancing to SME status.

Required experience includes TRICARE contract claims processing and data analysis, with strong written and verbal communication. U.S. citizenship and NBIS clearance are required, with rare travel for training or meetings.