Humana is hiring work at home in most states.
Humana is a huge health insurance company. Humana makes over $64 billion a year. This health insurance giant is a Fortune 500 company. They are hiring remote claims representatives.
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Description
The Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for and against the organization. The Claims Research & Resolution Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Responsibilities
Where you Come In
The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services in the settlement of claims. Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
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.
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Required Qualifications – What it takes to Succeed
• High School Diploma or equivalent
• Previous Call Center experience – this is an inbound call center type of environment
• Experience working in a production environment
• This is a position Monday-Friday 8-4:30EST, no flex hours
• Ability to interact telephonically with members and/or agents
• Capacity to maintain confidentiality
Preferred Qualifications
• Bachelor’s Degree
• CRM knowledge
• Prior claims knowledge
• Subrogation or SIU experience
• Troveris
Additional Information – How we Value You
• Benefits starting day 1 of employment
• Competitive 401k match
• Generous Paid Time Off accrual
• Tuition Reimbursement
• Parent Leave
• Go365 perks for well-being
• Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work.
• Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M
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