Humana Authorization Data Analyst - Boca Raton, FL in Boca Raton, Florida

Role:Authorization Data Analyst

Assignment:Humana Long- Term Care

Location:Boca Raton, FL

We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our consumers, providers, employers, agents and others we work with. At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our members, employers, providers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.

Assignment Capsule

Humana Long-Term Care is seeking Authorization Data Analysts to ensure accurate, timely and consistently updated data, submitted by the Care Coach staff is translated and entered into Humana Long-Term Care's databases.

Job Functions

  • Act as liaison between the Care Coaches and Claims functions for proper processing and invoicing of Authorizations.

  • Interprets and translates submitted authorizations and status changes.

  • Consistently documents clear communications for proper invoicing criteria to providers and the claims department.

  • Identify and resolve non-compliant authorizations by communicating with Care Coaches to clarify intent and make required adjustments to satisfy expected outcomes.

Role Essentials

  • High School Diploma or equivalent.

  • Basic knowledge of Microsoft Office programs.

  • Excellent written and verbal communication skills.

  • Must be very detailed oriented.

Role Desirables

  • Detailed understanding of claims processing for contracted and non-contracted claims.

  • Must be able to understand Long Term Care claims including but not limited to Home Health and CMS claims.

  • Knowledge of Assisted Living, Skilled Nursing Facility and Hospice billing requirements.

  • Previous Scheduling Specialist/Coordinator experiences preferably, in a home health setting.

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. If you share our passion for helping people, we likely have the right place for you at Humana.

Interview Format.

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence(please be sure to check your spam or junk folders often to ensure communication is not missed)inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Title: Authorization Data Analyst - Boca Raton, FL

Location: FL-Boca Raton

Requisition ID: 178534