South Carolina, United States · Hybrid
$40k–$52k/yr
Become a part of our caring community The Medical Records Retrieval Specialist conducts quality assurance audits of medical records and ICD‑9/10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services…
Skills: Medical Records Retrieval, Quality Assurance Auditing, ICD-9/10 Coding, HIPAA Compliance, Customer Service
North Carolina, United States · Remote OK
$98k–$134k/yr
Become a part of our caring community The Senior Informaticist coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Senior Inf…
Skills: Data Analytics, Predictive Modeling, Data Mining, SQL, Python
United States · Remote OK
$65k–$89k/yr
Become a part of our caring community The Formulary Operations Management Professional 2 provides operational leadership for build, maintenance, submission, and updating of formularies and drug lists. The Formulary Opera…
Skills: Formulary Management, Process Improvement, Data Analysis, Relationship Building, Consultative Skills
New York, New York, United States · Remote OK
$104k–$142k/yr
Become a part of our caring community Humana: A Fortune 60 Healthcare Company Humana is a publicly traded, Fortune 60 health benefits company with a long history of successful innovation and reinvention. It has transform…
Skills: Strategy Consulting, Quantitative Analysis, Qualitative Analysis, Financial Analysis, Market Research
United States · Remote OK
$107k–$147k/yr
Become a part of our caring community Humana's Stars is an organization that improves health outcomes and improves the care experience of our members and provider partners through quality solutions. Stars is committed to…
Skills: Vendor Management, Clinical Abstraction, Data Quality Management, HEDIS, Medical Record Review
United States · Remote OK
$39k–$49k/yr
Become a part of our caring community As a remote Utilization Management (UM) Administrative Coordinator you will report to a Supervisor of Referrals and support the Behavioral Health (BH) UM department and perform varie…
Skills: Data Entry, Customer Service, Medical Terminology, ICD-10 Codes, Electronic Medical Records
Washington, District of Columbia, United States · Remote OK
$48k–$66k/yr
Become a part of our caring community The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) a…
Skills: ICD-10 Coding, Risk Adjustment, HCC Coding, Medical Record Review, Quality Assurance
United States · Remote OK
$73k–$100k/yr
Become a part of our caring community The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2…
Skills: Data Analysis, Predictive Modeling, Data Mining, Problem Solving, Microsoft Office
United States · Remote OK
$126k–$174k/yr
Become a part of our caring community A lead product manager manages multiple simultaneous projects and oversees all aspects of each project, from conception to completion. Lead product managers may also task themselves …
Skills: Product Strategy, Roadmap Development, Mobile App Management, Customer-centered Design, Agile Methodology
Lexington, Kentucky, United States · Hybrid
$80k–$125k/yr
Become a part of our caring community With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when…
Skills: Medicare Sales, Grassroots Marketing, Relationship Building, Public Speaking, Salesforce
United States · Remote OK
$59k–$68k/yr
Become a part of our caring community The Subrogation Professional 2 investigates accident, injury, and claim events to determine whether Humana may have the right to recover claim payments from another responsible party…
Skills: Subrogation Claims Handling, Lien Negotiation, Customer Service, Microsoft Word, Microsoft Excel
United States · Remote OK
$126k–$174k/yr
Become a part of our caring community The Data Product & Strategy Lead drives enterprise value by developing automation opportunities across CenterWell segments, including Home Health, Primary Care, and Pharmacy. You…
Skills: Process Mapping, Data Analysis, Automation Strategy, AI/ML, Generative AI
United States · Remote OK
$157k–$215k/yr
Become a part of our caring community The Director, Behavioral Economics Nudge Unit is the expert leader and internal face of Humana’s industry-leading Behavioral Economics team. The Director, Behavioral Economics Nudge …
Skills: Behavioral Economics, Causal Inference, People Leadership, Stakeholder Management, Behavior Change Interventions
Puerto Rico, Texas, United States · Remote OK
Become a part of our caring community The CarePlus Medicare Call Center Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries from Medicare members. The CarePlus Medicare…
Skills: Bilingual English/Spanish, Customer Service, Active Listening, Microsoft Outlook, Microsoft Teams
Washington, District of Columbia, United States · Remote OK
$118k–$162k/yr
Become a part of our caring community ** Selected candidate(s) are required to live within 60 mins drive of the following cities. (Louisville KY, NYC Metro, Dallas Metro, Charlotte NC Metro, South Florida(Tampa/Miami/Ft …
Skills: Cybersecurity Engineering, Azure, GCP, CI/CD Pipelines, Python
Carapichaima, Couva-Tabaquite-Talparo, Trinidad and Tobago · Remote OK
$115k–$158k/yr
Become a part of our caring community The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The…
Skills: Regulatory Compliance, Risk Assessment, Medicaid Operations, Auditing, Contract Compliance
Cincinnati, Ohio, United States · Hybrid
$80k–$125k/yr
Become a part of our caring community With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when…
Skills: Medicare Sales, Grassroots Marketing, Relationship Building, Public Speaking, Salesforce
United States · Remote OK
$107k–$147k/yr
Become a part of our caring community The Senior Database Engineer leads important projects in design, development, implementation and management of databases. The Senior Database Engineer work assignments involve modera…
Skills: ETL, SSIS, SSMS, SQL, Python
United States · Remote OK
$126k–$174k/yr
Become a part of our caring community The CRM Marketing Lead for CenterWell Customer Onboarding, Retention and Engagement defines and drives the strategic vision for customer lifecycle marketing initiatives that accelera…
Skills: Lifecycle Marketing, Customer Engagement, Omni-channel Marketing, Journey Orchestration, CRM Tools
Baton Rouge, Louisiana, United States · Hybrid
$71k–$98k/yr
Become a part of our caring community The Field Care Manager Nurse (Physical Health) plays a critical role in assessing and coordinating care to support members in achieving and maintaining health outcomes. The Field Car…
Skills: Case Management, Clinical Assessment, Care Coordination, Patient Advocacy, Electronic Medical Records
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Conduct quality assurance audits of medical records and ICD codes submitted to government agencies. Retrieve, review, and validate medical records on-site at provider offices while maintaining strict PHI confidentiality.
Requires at least one year of experience in customer service and medical records, along with a valid driver's license and reliable transportation. Proficiency in Microsoft Office and knowledge of healthcare environments or managed care is necessary.
The Medical Records Retrieval Specialist performs moderately complex administrative and operational tasks in a remote and field‑based, structured environment, with a focus on accuracy, compliance, and efficiency.
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:
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
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. This policy shall apply to all 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 all levels of employment.
Humana will never ask, nor require a candidate to provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact [email protected] to validate the request At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
Offices: 500 W Main St, Louisville, Kentucky, US · 550 W Adams St, Chicago, IL 60661, US
Humana will never ask, nor require a candidate to provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact [email protected] to validate the request At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
Offices: 500 W Main St, Louisville, Kentucky, US · 550 W Adams St, Chicago, IL 60661, US
