Customer Service - Claims Processor (Work from Home)

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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. 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.

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.

Proficiency in all Microsoft Office: Word, PowerPoint, Excel

1+ years of experience within the healthcare and/or insurance industries

• Customer service experience
• CAS Claims processing experience
• Bachelor's Degree

Training:

IN PERSON training starts day one of employment and will run for 6 weeks with a schedule of 8:00AM-4:30PM Eastern Monday - Friday.

Work Schedule Following Training:

Following training and appraisal period, associates will transition to Work From Home and required to work a schedule of: 8:00AM-4:30PM Eastern Monday-Friday.

This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.

The department has a strict attendance policy. This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) ****

Shortly after submitting your application, you may receive both a text message and email requesting you to complete 5-10 prescreen questions.

Video Prescreen: You will receive another communication to record a Video Prescreen. This is an online video activity using your phone, tablet, or computer.

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. 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Humana: Humana Inc. (S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. 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, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.