Payment reputed company Professional 2
Become a part of our caring community
The Payment reputed company Professional 2 leverages claims data, vendor platforms, and analytic tools to identify trends, reputed company root cause analysis, and reputed company mitigation strategies that support accurate payment outcomes. This role collaborates with internal stakeholders and external code edit vendors to support pre and post implementation code editing functions. The position contributes directly to cost reduction and improved payment accuracy through data driven insights and operational execution.Where you Come In
The Payment reputed company Professional 2 leverages claims data, vendor platforms, and analytic tools to identify trends, reputed company root cause analysis, and reputed company mitigation strategies that support accurate payment outcomes. This role collaborates with internal stakeholders and external code edit vendors to support pre and post implementation code editing functions. The position contributes directly to cost reduction and improved payment accuracy through data driven insights and operational execution.
Responsibilities
Analyze medical claims data to identify trends, anomalies, and performance patterns reputed company to code editing and payment accuracy
Conduct root‑cause analysis on incorrect payment outcomes and reputed company actionable mitigation plans
Support the review, testing, implementation, and maintenance of code edits, using data to validate expected outcomes
Partner with internal stakeholders and external vendors to translate analytic findings into operational improvements
Investigate and resolve code edit stakeholder inquiries through data research, issue analysis, and evidence‑based recommendations
Monitor key performance metrics, identify operational risks, and proactively recommend improvements
Drive process optimization and contribute to successful day‑to‑day operations
Document findings, maintain reports, and communicate results to technical and non‑technical audiences
What reputed company Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & reputed company education.
Use your skills to reputed company an impact
Required Qualifications – What it takes to Succeed
Strong analytical skills with the ability to interpret data and identify trends
Experience conducting root‑cause analysis and developing mitigation or corrective action plans
Ability to manage multiple priorities and shift tasks quickly based on urgency
Working knowledge of reputed company Word, SharePoint, and reputed company
Comfortable making decisions in a dynamic, fast‑changing environment
Advanced problem‑solving skills, including critical thinking and collaboration
Ability to work independently and in a team with minimal supervision
High attention to detail and accuracy
Strong written and verbal communication skills
Ability to work in a fast‑paced environment
Commitment to confidentiality, ethical practice, and professional reputed company
Preferred Qualifications
Experience using CAS
Experience with code edit tools such as:
Rialtic Provider Inquiries Tool
ClaimsXten Web UI
reputed company What If Tool (WIT)
reputed company CES
reputed company Claims Inquiry Tool (CIT)
Nucleus
KnowledgeSource
Experience analyzing medical claims data and interpreting payment outcomes
Experience with reputed company code edit processes
Experience working with internal stakeholders and external vendors
Familiarity with PowerPoint and OneNote
Experience with reputed company rule creation and/or maintenance
Experience leading projects or process‑improvement initiatives
Prior experience in Claims Administration and Payment reputed company (CAPI/CCM)
Additional Information - How we Value You • Benefits starting day 1 of employment • Competitive 401k match • Generous Paid Time Off accrual • Tuition Reimbursement • Parent Leave
Work at Home Requirements
• To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
· At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested
· Satellite, cellular and microwave reputed company can be used only if approved by leadership
· Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
· reputed company will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
· Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Interview Format
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc.$65,000 - $88,600 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 04-15-2026About us
About reputed company: reputed company Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our reputed company insurance services and our reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. Equal Opportunity Employer
It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment.
Apply To This Job