Claims Processing Representative

Job Overview Claims Processing Representative 2 reviews and adjudicates complex or specialty claims submitted via paper or electronically. Performs computations and semi‑routine assignments. Determines whether to return, deny, or pay claims following organizational policies. Key Responsibilities Review and adjudicate complex or specialty claims. Make decisions to return, deny, or pay claims consistent with policies. Perform calculations related to claim processing. Use multiple computer systems simultaneously. Prioritize and manage work within defined parameters. Required Qualifications Analytical thinking skills; comfortable working independently and with minimal supervision. Experience handling multiple computer systems simultaneously. Ability to manage multiple or competing priorities. Excellent verbal and written communication skills. Proficiency with Microsoft Office (Word, PowerPoint, Excel). Must reside within 50 miles of 101 E. Main St, Louisville, KY 40202. Preferred Qualifications 1+ year experience in healthcare and/or insurance industries. Customer service experience. Passion for continuous improvement of consumer experiences. CAS claims processing experience. Bachelor’s degree. Training & Work Schedule Position starts Tuesday, September 8, 2026. In‑person training begins day one of employment and runs for 6 weeks, Monday–Friday 8:00 a.m.–4:30 p.m. Eastern Time. Following training, the associate will transition to a work‑from‑home schedule, Monday–Friday 8:00 a.m.–4:30 p.m. Eastern Time. The first 120 days constitute an appraisal period with a strict attendance policy. Pay Range $40,000 – $52,300 per year. Benefits Humana offers medical, dental, vision, 401(k), paid time off, parental and caregiver leave, short‑term and long‑term disability, life insurance, and other benefits supporting well‑being. Equal Opportunity Employer Humana does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It also adheres to affirmative action policies in compliance with applicable laws. #J-18808-Ljbffr Humana