[Remote] Home Healthcare Revenue Cycle EDI Systems Analyst

Note: The job is a remote job and is open to candidates in USA. Humana is a leading healthcare services company focused on creating integrated and personalized experiences for patients. The Revenue Cycle EDI Systems Analyst will support and optimize revenue cycle systems, ensuring accurate billing and compliance while collaborating with various teams to enhance system performance.ResponsibilitiesSupport and configure revenue cycle applications utilized for billing and claims managementIdentify and implement process improvements to reduce denials and accelerate reimbursementsCollaborate with FSU, IT and vendors to troubleshoot and resolve system issues and coordinate upgrades or integrationsMonitor revenue cycle metrics such as errors, rejections and denial ratesUtilize dashboards and reports to track and identify billing and collections trendsProvide actionable insights to leadership for decision-makingEnsure systems align with CMS, HIPAA, and payer requirementsRespond to internal and external audit and data requestsSupport staff with system use and system issuesManage, analyze, and optimize electronic data transactions (837, 835, 270/271, etc.) between the FSU and external vendorsCollaborate with clearinghouses and payers to resolve transmission, billing and adjudication errorsEnsure timely submission of claims and receipt of remittance advicePartner with internal and external teams to ensure system functionality supports departmental and company goalsWork with finance to reconcile payments and resolve discrepanciesSupport and train staff on System functionality, EDI processes and best practicesEvaluate current workflows and recommend enhancements to improve efficiency, reduce costs, and ensure accurate and timely billingCollaborate with cross-functional teams to implement new procedures and track effectivenessSkills3 or more years of experience in healthcare revenue cycle and EDI, preferably in home health or post-acute careStrong knowledge of HIPAA transactions (837, 835, 270/271, etc.), EMR/EHR systems, and clearinghouse platformsAnalytical skills with proficiency in Microsoft Office applicationsUnderstanding of healthcare regulations, reimbursement models, and compliance standardsExcellent problem-solving, communication, and organizational abilitiesBachelor's degree in Health Information Management, Computer Science, Business Administration, Healthcare Management, Data Analytics or related field, or equivalent experienceExperience with revenue cycle automation tools and workflow optimizationFamiliarity with Medicare/Medicaid billing processes specific to home healthProficiency in file transfer softwareProject management or process improvement experienceBenefitsMedical, dental and vision benefits401(k) retirement savings planTime off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)Short-term and long-term disabilityLife insuranceEmployees 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 expenseHome or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/jobCompany OverviewHumana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is http://www.humana.com.Company H1B SponsorshipHumana has a track record of offering H1B sponsorships, with 91 in 2026, 282 in 2025, 246 in 2024, 284 in 2023, 274 in 2022, 212 in 2021, 84 in 2020. Please note that this does not guarantee sponsorship for this specific role.