[Hiring] Claims Research and Resolution Representative @Humana

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Role Description

Join Humana’s dynamic team as a Claims Research & Resolution Representative and make a meaningful impact every day! In this vital role, you’ll be at the heart of our claims operations—connecting with providers and members to resolve and settle claims that shape the health industry.

• Leverage your expertise and independent judgment to investigate cases, approve settlements, and navigate complex administrative challenges.
• Collaborate with dedicated associates and exercise your problem-solving skills.
• Work with providers, members, and third-party collection services to facilitate timely and accurate resolution of complex medical claims.
• Regularly exercise discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques.
• Demonstrate a high level of autonomy, leveraging experience and organizational knowledge to resolve claims inquiries.

Qualifications

• 2+ years of customer service and/or claims experience.
• Proficient in Microsoft Office applications (Outlook, Word, Teams, Excel).
• Capacity to maintain confidentiality.
• Knowledge of healthcare terminology.

Requirements

• Medical claims processing experience (preferred).

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.

Interview Process

• Video Prescreen: Shortly after submitting your application, you may receive both a text message and email requesting you complete a Video Prescreen.
• Interviews: Some candidates will be invited to interview.
• Offers: Finalists from the interview will be contacted by a recruiter to discuss an offer for the job.

Scheduled Weekly Hours

• 40 hours per week.

Pay Range

• $43,000 - $56,200 per year.