Claims Research & Resolution Representative 2

Join Our Caring Community

Become a part of our caring community and help us put health first. The Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and resolution of claims or claims-related financial issues. The position includes moderately complex call center, administrative, operational and customer support assignments. Workload is typically semi-routine assignments along with intermediate level math computations. This is an opportunity to work remotely and use your research, resolution and customer service skills to join a Fortune 100 company with a great culture and outstanding benefits.

Humana values associate engagement and well-being. We also provide excellent professional development and continued education.

The claims inbound call center is comprised of a group of calls / claims / provider associates researching the resolution to a pending call. The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services in the resolution of claims. Responsibilities include :

• Taking inbound calls to address customer needs which may include complex financial recovery, answering questions, and resolving issues.
• Recording notes with details of inquiries, comments or complaints, transactions or interactions and taking action accordingly.
• Escalation of unresolved and pending customer inquiries.

Decisions are typically focused on interpretation of area or department policy and methods for completing assignments. Standard policies and practices allow for some opportunity for interpretation / deviation and / or independent discretion. Work is within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization and timing, and works under minimal direction.

Required Qualifications

To qualify, you must have :

Required Work Schedule

Training :

Work Hours

Following training, must be able to work an assigned 8-hour shift between the hours of 8 : 00 AM to 6 : 00 PM Eastern. Overtime may be offered, based on business needs.

Preferred Qualifications

To further enhance your application, consider having :

Additional Information

Please make sure you attach your resume to your application (PDF or Word format).

Work at Home Guidance :

Interview Process

As part of our hiring process for this opportunity, we will be using technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 per year.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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.

About Us

Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status