Description
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.
Responsibilities
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
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