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Humana Compliance Letters Specialist /Compliance (UM) Letters Coordinator 2 (Central Standard Time Zone) in Billings, Montana

Description

The Compliance (UM) Coordinator 2 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

The Compliance (UM) Coordinator 2 collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. Ensures mandatory reporting completed. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Mandatory weekend/holiday On Call rotation for compliance timeframes and QIO appeals

Required Qualifications

  • High School Diploma

  • Previous experience working in a compliance or utilization review setting

  • High attention to detail and accuracy

  • Proficiency in all Microsoft Office applications, including Word, Excel and Outlook

  • Excellent communication skills, both verbal and written

  • Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems

  • Excellent organizational and time management skills

  • Ability to work independently under general instructions and with a small team to meet compliance timeframes

  • 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

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

  • Mandatory weekend/holiday On Call rotation for compliance timeframes and QIO appeals

Preferred Qualifications

  • Associate’s or Bachelor’s Degree in Business, Finance or a related field

  • Familiarity with CMS guidelines, Medicare experience, knowledge of appeal process.

Additional InformationHours for this role are between Monday-Friday 8:30am-6:30pm CST

If you are selected for a phone screen you will receive an email inviting you to participate in a Montage /Text Voice interview. During this call you will be asked a set of questions pertaining to this particular role and you will provide recorded responses. The entire process takes about 15-20 minutes and can be done at your convenience. Your responses will be reviewed and you will be informed if you were selected for an in person or video interview, depending on your location.

If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.

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