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The Supervisor, Encounter Data Management develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long term improvements of encounter submission processes. Decisions are typically related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.
The Supervisor, Encounter Data Management ensures data integrity for claims errors. The Supervisor, Encounter Data Management works within thorough, prescribed guidelines and procedures. You will use, requiring analysis of variable factors to solve basic problems. Additionally, the Supervisor collaborates with management and top professionals/specialists in the selection of methods, techniques, approach. You will report to the Manager, Encounter Data Management.
Performance
- Meet deadlines with attention to detail
- Demonstrated ability to give direction
- Proven ability to collaborate with multiple departments
- Deliver presentations to senior leadership
Use your skills to make an impact
Required Qualifications
- 2+ years Medicare and/or Medicaid claims processing experience
- Internal and external error claim processing
- 2+ years of formal or informal leadership experience
- 1+ years' experience working in CAS, Edifecs, Optum and similar DOS 835/837 warehouse systems
- 2 years+ of advanced Microsoft Excel (VLOOKUP, Pivot Tables and ability to create macros)
- 1 year+ SQL experience (running queries)
Preferred Qualifications
- Bachelor's Degree
- 1+ years' experience in encounter submissions background
- Certification in Six Sigma or Project Management
- Prior Experience in healthcare or insurance setting
Additional Information
Work-At-Home Requirements
- Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
- A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
- Satellite and Wireless Internet service is NOT allowed for this role.
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$65,000 - $88,600 per year
This job is eligible for a bonus incentive plan.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off, disability, life insurance and many other opportunities.
Application Deadline: 06-05-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.