Health Information Management Professional - Louisville, KY

Louisville, Kentucky

Posted in Insurance
6 days ago

Job Info


Do you have an analytical mindset? Do you find yourself researching to find the root cause of a problem? If so, this position is for you! The Health Information Management Professional will identify complex errors and problems within the encounter process between Humana and CMS using data analysis, claims research, and other resources to provide insight. Health Information Management Professional 1 ensures data integrity for claims errors. This role is responsible for the development of new strategies and processes that decreases the amount of errors that come back from CMS. Partnership with departments and communication with the leadership of those departments to highlight impacts that will result in change by the responsible department that ultimately will decrease the amount of errors.


The Health Information Management Professional 1 develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

Required Qualifications

  • 2+ years claims experience (processing, research, or related field)
  • 1+ year in data analysis, critical thinking, and analytical problem solving experience
  • Prior experience in project management or handling multiple initiatives in a deadline/fast paced environment
  • Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel
  • Reasonable commutable distance to Louisville, KY
  • Must have accessibility to high speed DSL or Cable modem for Home Office. Optimal performance speed for Humana systems is 10Mx1M
Preferred Qualifications

  • Bachelor's degree or Master's Degree in Business Administration or a related field
  • Prior health insurance industry experience
  • Working knowledge of Microsoft SQL or SAS
Additional Information

Position is temporary WAH Louisville, KY due to Covid-19. This position will reenter the office when deemed safe to return.

Scheduled Weekly Hours


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