Company name
Humana Inc.
Location
Pittsburgh, PA, United States
Employment Type
Full-Time
Industry
Accounting
Posted on
Feb 03, 2022
Profile
Description
The Claims Cost Management team audits claims submitted by providers. We look at all aspects of the claim to find overpayments and our savings forecasts become a crucial piece of Humana's financial goals and bidding process. As a Provider Payment Integrity Professional 2 on the Claims Cost Management team, you will provide support through data analytics and testing for database projects . You will complete analyses and prepare documentation materials while interacting and building partnerships with Humana's internal Clinical Auditing, Finance, and Information Technology teams. Most directly, this role will impact how the Claims Cost Management group builds financial projections and analyzes savings found through clinical claims audits.
Responsibilities
This role will take on many tasks, including the following:
Test and validate financial models to help better project financial goals for the clinical claims auditing programs.
Gather business logic and provide feedback for dashboards and data models.
Manage special projects and report builds - monitoring progression, reviewing assumptions and tracking changes.
Collaborate with finance stakeholders and operational leaders to gather input and assumptions.
Build documentation for data processes and forecasting models.
Pioneering analytics by using new and existing reporting.
COME GROW WITH HUMANA! BENEFITS DAY ONE - STELLAR 401K MATCH - PAID TIME OFF - TUITION ASSISTANCE PROGRAMS - STELLAR WELLNESS/REWARDS PROGRAM
Role Essentials
Bachelor's Degree
Comprehensive knowledge of Microsoft Office Suite
SQL Database experience
2-3 years' experience in an accounting or finance role
Project initiative background - ability to push to make things happen, meeting deadlines, bringing individuals together, along with ability to challenge when necessary.
Excellent communication skills, both written and verbal
Excellent presentation skills
Preferred Qualifications
Power BI and database proficiency
2-3 years' experience in a data analytics
Work at Home Requirements
Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Additional Information - How we Value You
Health/Vision/Dental Benefits Effective day one
Competitive pay/salary ranges
PTO
VTO day
Associate Incentive Plan
401K Match- Immediate company match of 125 percent on the first 6 percent of your pretax 401(k) or Roth 401(k) contributions.
Well-being program
Tuition Reimbursement
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com