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[Remote] Home Healthcare Claims Pre-Billing Audit Manager
Note: The job is a remote job and is open to candidates in USA. Humana is a leading healthcare company dedicated to putting health first. The Manager of Pre-Bill Audit will provide strategic leadership and operational oversight for the organization’s pre-billing function, ensuring claims are audit-ready and driving improvements in revenue cycle performance and compliance.
Responsibilities
- Establish and execute the vision for centralized pre-billing aligned with organizational revenue cycle strategy
- Drive standardization of processes across markets, ensuring consistent application of billing readiness practices
- Develop performance dashboards, KPIs and SLAs to measure team effectiveness and financial impact
- Lead and mentor Pre-Bill Supervisors to ensure timely and accurate claim readiness across multiple regions
- Monitor national unbilled metrics and implement action plans to sustain improvement
- Oversee audit readiness for Medicare, Medicaid and commercial payers; ensure pre-billing activities meet compliance standards
- Serve as the escalation point for complex payer issues, systemic process barriers or cross-functional challenges
- Partner with Region and Area leadership, Finance, Compliance, and other corporate teams to align pre-billing strategy with enterprise goals
- Collaborate with IT and HCHB support teams to optimize system workflows, reporting and automation opportunities
- Provide updates to executive leadership on performance, risks and opportunities for scale
- Build a high-performing centralized team through effective recruiting, onboarding, coaching and talent development
- Foster a culture of accountability, continuous improvement and data-driven decision-making
- Support professional growth and career pathing for Pre-Bill Supervisors and Specialists
Skills
- Bachelor's degree in healthcare administration, business, or a related field; in lieu of a degree, a minimum of 8 years of home health experience, including at least 2 years in a leadership role
- 2+ years of experience in a leadership role
- 7+ years of experience in home health
- Deep knowledge of Medicare and Medicaid billing requirements
- Proven ability to lead large, distributed teams and manage to performance targets
- Exceptional communication, relationship-building and change-management skills
- Strong analytical and problem-solving abilities, with demonstrated success in using data to drive operational decisions
- Strong understanding of system workflows in Homecare Homebase (HCHB) preferred
Benefits
- Health benefits effective day 1
- Paid time off, holidays, and jury duty pay
- Recognition pay
- 401(k) retirement savings plan with employer match
- Tuition assistance
- Scholarships for eligible dependents
- Caregiver leave
- Employee charity matching program
- Network Resource Groups (NRGs)
- Career development opportunities
- Medical, dental and vision benefits
- 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
Company Overview
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