Strategic Encounter Data Governance Architect



The Senior Encounter Data Management Professional


  • Develops and maintains business processes for timely and error-free submissions of encounters to Medicaid/Medicare.
  • Ensures encounters with errors meet or exceed service level agreements through reporting, collaboration, trending, and inventory management.
  • Looks for long-term improvements in encounter submission processes and influences departmental strategy.
  • Makes decisions on reporting needs, inventory management, and efficiencies to improve departmental productivity.

Responsibilities (Contd.)

  • Helps ensure encounters with errors meet or exceed service level agreements for Medicaid/Medicare through report monitoring and trending.
  • Utilizes tools such as Excel, SQL, or PowerBI for daily inventory reporting and collaborates with different departments for success.
  • Works closely with peers to understand errors in open inventory and develops necessary reports to monitor trends and escalate when necessary.

Required Qualifications

  • 2 or more years of health insurance experience
  • Medical claims processing experience
  • Strong analysis, critical thinking, and analytical problem-solving skills
  • Prior experience with developing and trending reports
  • Ability to manage multiple tasks and deadlines with attention to detail
  • Excellent communication skills
  • Self-starter, ability to work independently
  • Comprehensive knowledge of all Microsoft Office applications, including Word, PowerPoint, Outlook, and Excel

Preferred Qualifications

  • 1 or more years of experience with writing SQL queries
  • 1 or more years of experience with developing PowerBi dashboards
  • Prior experience with CAS and EHUB
  • Prior experience with Medicare and Medicaid programs

Additional Information

Work-At-Home Requirements

  • Must have the ability to provide a high-speed DSL or cable modem for a home office.
  • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Process

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor…

Scheduled Weekly Hours


Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment…

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being…

Apply Now
Contact Fiverrpromotion through whatsapp 0