Claims Processing Representative 2

Humana Remote
representative training representative assignments microsoft consumer excel healthcare administrative operational customer support procedures quality standards
December 5, 2022
Humana
Louisville, KY
FULL_TIME

The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.


Responsibilities


The Claims Processing Representative 2 determines whether to return, deny, or pay claims following organizational policies and procedures. 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.


COME GROW WITH HUMANA! BENEFITS DAY ONE – STELLAR 401K MATCH – PAID TIME OFF – TUITION ASSISTANCE PROGRAMS – STELLAR WELLNESS/REWARDS PROGRAM

What you need for success! - Required Qualifications


  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

  • Must have 2 years of customer service experience

  • Proficiency in Microsoft Word, PowerPoint and Excel as well as comfortable working within multiple programs and systems daily

  • Analytical thinking skills and comfortable working independently and with minimal supervision

  • Excellent verbal and written communication skills

  • The ability to work professionally and within designated time frames

  • Training Schedule (Monday-Friday, 8 am - 4:30 pm). After training, the schedule will be determined between associate and leader.

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


  • Proficiency in all Microsoft Office: Word, PowerPoint, Excel, and Access

  • CAS Claims processing experience

  • Bachelor's Degree

  • 1 years of experience working within a similar environment

  • 1 years of experience within the healthcare and/or Insurance industries

  • Proficient in Microsoft Access


Additional Information


  • Will work at the following location: 101 E. Main St, Louisville, KY 40202

  • This position offers approximately 6 weeks of traditional in-office training. Employees will remain in the office 90 after training, then will have the option to work from home.

  • Please note that training is a critical stage of associate development. Any time off or scheduled obligations during the training period will need to be reviewed as part of the selection process.


Work-At-Home Requirements


  • WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 25x10 (25mbps download x 10mbps upload) is required.

  • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Covid-19 Vaccine Requirement


  • We will require full COVID vaccination for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve.

  • If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.


Scheduled Weekly Hours


40

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