[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 • Humana 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 Sponsorship • Humana has a track record of offering H1B sponsorships, with 202 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. Apply tot his job Apply To this Job