**Become a part of our caring community and help us put health first** The Senior Billing & Enrollment Professional is responsible for the accurate enrollment and billing process for an insurance organization. The Senior Billing & Enrollment Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Sr Billing and Enrollment Professional is responsible for research and resolution of complicated and difficult enrollment and billing issues. The role owns developing and maintaining billing and enrollment various reports. Overall department Data steward. **KEY ACCOUNTABILITIES** + Implement self-directed activities to analyze, coordinate, process, and complete action to correct multifaceted problems relating to eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics. + Manage and maintain all billing and enrollment reports. Responsible for DHA and HGB systems and platforms. Owns documentation and development of all business requirements related to reports, data analysis, and process improvement. . Conducts annual review of all policy and procedures. Billing and Enrollment department data steward. + Maintains related documents, updates corresponding records, and responsible for enrollment and billing query. May be responsible for or assist in addressing broad, complex enrollment and billing issues. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Required Qualifications** + Our Department of Defense contract requires U.S. Citizenship + Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services) + HGB is not authorized to do work in Puerto Rico per our government contract. **We are not able to hire candidates that are currently living in Puerto Rico.** + 5 years of healthcare technical experience – knowledge of TRICARE Systems – DEERs/enrollment system, TIP 360, WPS system + Proficient with MS Office tools. Excel - being able to sort/filter data, create new spreadsheets, and basic formulas for grouping/sorting + Process improvement recommendation experience + TRICARE rules/regulation experience **Preferred Qualifications** + Bachelor's degree **Work-At-Home Requirements** + WAH 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 **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. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) 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 outside of work. Among our benefits, Humana 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. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.