[Remote] Senior Encounter Data Management Professional at Humana

The Senior Encounter Data Management Professional is responsible for developing business processes to ensure the successful submission and reconciliation of encounter data to Medicaid/Medicare, meeting or exceeding all compliance standards through data analysis. They will develop tools to improve the encounter acceptance rate and drive long-term improvements in encounter submission processes. This role involves ensuring data integrity for claims errors resulting from data exchange with trading partners, Medicare, and Medicaid. The professional will collaborate with department leadership, trading partner owners, and the error resolution team to address and improve error submission issues. They will also be tasked with problem-solving and removing roadblocks that hinder timely encounter data submission to trading partners. This includes analyzing data, trends, and system limitations to create and implement long-term improvements that enhance encounter submissions, addressing moderately complex to complex issues requiring in-depth evaluation of variable factors.