Manager Provider Claims Pend Group Green Bay

Profile

Description

The Manager, Provider Pend Group administers the process of resolving provider data records based on claims that pend in Humana's claims system. This individual performs set-up, database loading and preparation of administrative documents and materials. The Manager will lead a team of approximately 75-80 associates which includes off-shore and will be located in Green Bay, WI.

Responsibilities


Oversee daily operations and successfully leads the Provider Pend Group which includes coaching and developing 75-80 on and off-shore associates
Maintains inventory, aging, and quality goals for resolution of pended claims
Collaborates closely with provider claims and provider installation teams
Responsible for monitoring and meeting compliance including federal or state regulations and contract requirements


This role is temporarily remote, but once CDC restrictions are lifted it will be both, in-office and work-from-home.

Required Qualifications


Bachelor's Degree or equivalent related work experience
4 years of provider and/or claims data experience (i.e. provider office environment, claims, billing, etc.)
2 years of people management experience
Experience leading/managing projects
Strong computer skills including Microsoft Office
Demonstrated success working in collaboration with multiple departments and disciplines
Demonstrated competency in both oral and written communication skills
Solid understanding of process / work flow concepts
Excellent interpersonal and teamwork skills
Must be within 50 miles of Humana's Green Bay office


Preferred Qualifications


Knowledge of Humana claims payment systems
Experience leading a remote/virtual team including off-shore


Additional Information

At Humana, we know your well-being is important to you, and it's important to us too. That's why we're committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few:


Work-Life Balance
Generous PTO package
Health benefits effective day 1
Annual Incentive Plan
401K - Immediate company match
Well-being program
Paid Volunteer Time Off
Student Loan Refinancing


Covid-19 Temporary Work-At-Home In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. Work at Home/Remote Requirements


Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required


Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from **** with instructions to add the information into the application at Humana's secure website. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

Company info

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