Claims Research and Resolution

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

**PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (pdf or Word format) **

• 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.

COME GROW WITH HUMANA!

BENEFITS DAY ONE – STELLAR 401K MATCH – PAID TIME OFF – TUITION ASSISTANCE PROGRAMS – STELLAR WELLNESS/REWARDS PROGRAM

Required Work Schedule:

We are only considering candidates who live within 50 miles of the following Humana location:

101 E. Main St, Louisville, KY 40202

• Training: This position offers 7-9 weeks of traditional in-office training. Monday – Friday 8am – 4:30pm EST.
  • Please note that training is a critical stage of associate development. Attendance is vital for your success, so no time off, other than observed holidays, is allowed during training.
• After training, the schedule will be determined between associate and leader. Employees will remain in the office 90 days after training, then could have the option to work from home.

Required Qualifications - What you need for success!

• Analytical thinking skills and comfortable working independently and with minimal supervision
• Prior experience working with multiple computer systems at a time and multitasking through those effectively.
• Ability to manage multiple or competing priorities, including use of multiple computer applications simultaneously.
• Excellent verbal and written communication skills
• Proficiency in all Microsoft Office: Word, PowerPoint, Excel

Preferred Qualifications – What you need to STAND OUT among the crowd!

• 1+ years of experience within the healthcare and/or insurance industries
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• CAS Claims processing experience
• Bachelor's Degree

Additional Information

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

If you are selected for a first-round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will have a set of interview questions and you will provide recorded video responses to each question. You should anticipate this interview to take about 15 - 20 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

**PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (pdf or Word format) **

Scheduled Weekly Hours

40