- Remote, United States +1 more
- Remote
- Full-time · Senior
- $86K–$119K per year
- 2+ years
Locations (2)
- United States
- Louisville, Kentucky, United States
Compensation
$86,300 - $118,700 per year
Responsibilities
- Perform oversight audits of claims delegates to ensure compliance with state/federal regulations and Humana standards
- Serve as primary point of contact for assigned claims delegates
- Audit medical, mental health and vision claims and drive corrective actions
- Track, report, and communicate audit information to delegates and internal departments
- Prepare detailed audit reports and present findings to management
Requirements
- Bachelor’s degree
- Nice to have: delegation laws
- Nice to have: CMS
- Nice to have: NCQA
- Nice to have: audit methodology