Full Time
Louisville, KY
Posted 3 years ago

Humana

The Provider Connectivity Professional 2 provides analysis and support to both internal and external customers on complex EDI-related issues (i.e., electronic exchange of data including enrollment, claims, payments, and clearinghouse activities). The Provider Connectivity Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Provider Connectivity Professional 2 responds to complex inquiries relating to EDI from providers and internal departments. May help customers with modem set-up, connection protocols, etc. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

Bachelor’s degree or equivalent combination of education and experience

Strong knowledge of Microsoft products Excel, Access, PowerPoint, Visio

2 or more years of experience building reports in SSRS or a similar tool

1 or more years of experience with querying and extracting data from different data sources to include EDW, SQL, and Access databases

Ability to identify trends, communicate results, and make recommendations

Excellent organizational skills

Demonstrated verbal and written communication skills

Flexible and ability to adapt to change to support ongoing business needs

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

Preferred Qualifications

Strong knowledge of SQL

Experience with Availity BI

Experience in HIPAA X12 transactions; Claims Submission, Claims Status, Eligibility & Benefits and Referrals & Authorization

SharePoint knowledge

Knowledge of provider office processes and experience working in the provider space

Additional Information

Remote/Work at Home Requirements

Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours