Role: Compliance Auditor Assignment: Medicare Location: Work at home - Mountain or Pacific Time zones only
Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At Humana, we’re seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.
The Compliance Auditor position is a telecommuting role providing expert auditing, and documentation improvement education. This is a work at home position with the ideal candidate possessing the following: a clerical background requiring a high attention to detail; prior auditing experience; excellent communication skills both verbal and written; self-motivated with a process focus; and a healthcare background in medical billing and coding. To be considered for this role you must live in either the Mountain or Pacific Time zones.
Performs Verint validation reviews.
Utilizes audit tool(s)
Conducts reviews to ensure compliance with guidelines and provides reports to manager/leader as directed
Maintains strict patient health information confidentiality and follows all federal and state guidelines
Maintains current working knowledge, principles, government regulation, protocols
Ability to travel 10% or less of the work year for training, team meetings, possible onsite audits opportunities and implementation needs.
Strong organization skills
Ability to adapt to changes in process flows and policies
Ability to prioritize multiple duties and accomplish them in a timely manner with a high attention to detail
Strong communication skills both written and verbal
Computer proficient with MS Office products including; Excel, Word and Outlook
Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance for Humana systems is 10Mx1M
Prior auditing experience
Prior experience in a healthcare setting
You will report to a Clinical Manager.
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 isn’t 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: Compliance Auditor - Work at home in the Mountain or Pacific Time zones only
Other Locations: US-Washington-Vancouver, US-Oregon-Salem, US-Idaho-Meridian
Requisition ID: 179530
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.