Remote Encounter Data Supervisor - Medicaid/Medicare

Become a part of our caring community 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 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. Works within thorough, prescribed guidelines and procedures. Requires analysis of variable factors to solve basic problems. Collaborates with management and top professionals/specialists in selecting methods, techniques, and approaches. Reports 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 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 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 (25 Mbps download x 10 Mbps upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space with no 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. If selected to move forward, you will receive correspondence inviting you to participate in a pre‑recorded voice interview and/or an SMS text messaging interview. The pre‑recorded interview typically takes approximately 10–15 minutes. 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 based upon company and/or individual performance. Description Of Benefits Humana, Inc. and its affiliated subsidiaries offer 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. Application Deadline: 06-05-2026 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 – delivering the care and service they need, when they need it. 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. It is also the policy of Humana 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 base all employment decisions only on valid job requirements. #J-18808-Ljbffr Humana