Humana

Credentialing Assistant

Kentucky, United States

Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

Candidates should possess at least 1 year of administrative, support, data entry, or related professional experience, along with 1 year of experience in a metric/production driven environment. They must have comprehensive knowledge and proficiency in Microsoft Office Programs, including Word, Outlook, Excel, PowerPoint, and Teams, and be able to articulate ideas effectively in both written and oral forms. Applicants must meet Humana’s Work at Home connectivity requirements and may be asked to provide their Social Security Number.

Responsibilities

The Credentialing Assistant 3 will perform initial and recredentialing via APEX, correct errors identified by leadership via APEX, outreach to providers/facilities to obtain missing/expired information, manage their own time to accomplish necessary tasks on time, and help drive the timely credentialing and recredentialing initiatives needed to maintain Humana’s network. They will also ensure Humana’s policy remains in line with NCQA, URAC, and state requirements to maintain accreditation.”}​ Enforcing HIPAA guidelines while working remotely.

Skills

Microsoft Office
Word
Outlook
Excel
PowerPoint
Teams
Data Entry
Customer Support
Administrative Support
Time Management
Communication

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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