**Become a part of our caring community and help us put health first**

The Genetics Auditor performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Contributes to the investigations of fraud waste and our financial recovery. The Genetics Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

**Where you Come In**

The Genetics Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment. 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. Role includes review of suspected overpayments and underpayments to determine appropriate payment amounts based on the Genetics Auditor's expertise in their field.

**What Humana Offers**

We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education.

**Use your skills to make an impact**

**WORK STYLE:** Remote/Work at Home. Very rare travel/on sites for meetings, conferences, and/or trainings.

**WORK HOURS:** Monday-Friday, 8 hours/day, 5 days/week. Typical business hours range between 5AM-7PM EST (8 hours/day within those boundaries)

**Required Qualifications - What it takes to Succeed**

+ Bachelor's Degree

+ Genetic Counselor License

+ Minimum of 5 years work experience reading and interpreting medical claims

+ Comprehensive knowledge of Microsoft Office Programs Word, PowerPoint, and Excel

+ Strong attention to detail

+ Skilled in data and/or situational analysis

+ Can work independently and determine appropriate courses of action

+ Ability to handle multiple priorities

+ Capacity to maintain confidentiality

+ Excellent communication skills both written and verbal

+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences

**Preferred Qualifications**

+ Experience in Financial Recovery

+ Experience using the following systems: CAS, MTV, CISpro and CIS

+ Knowledge of Microsoft Office Programs Access and Project

+ Experience in a fast paced, metric driven operational setting

+ Bilingual in Spanish and English

**Additional Information - How we Value You**

* Benefits starting day 1 of employment

* Competitive 401k match

* Generous Paid Time Off accrual

* Tuition Reimbursement

* Parent Leave

**Work at Home Requirements**

* 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:

* At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

* Satellite, cellular and microwave connection can be used only if approved by leadership

* Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

* Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

* Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

**Interview Format**

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

**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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$84,600 - $116,300 per yearThis 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 because he or she is a protected veteran. 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.