Billing & Reconciliation Representative

Humana • Miramar, FL

3d • Hybrid

About The Position

Become a part of our caring community and help us put health first The Billing & Reconciliation Representative is responsible for identifying and resolving discrepancies between company records and those maintained by the Centers for Medicare and Medicaid Services. This role encompasses a range of moderately complex administrative, operational, and customer support tasks, including performing calculations and data analysis. Assignments are generally semi-routine in nature, requiring attention to detail and adherence to established procedures. The Billing & Reconciliation Representative performs monthly account reconciliations, thoroughly documenting any issues identified and developing actionable plans to resolve them. This role is committed to delivering exceptional customer service by keeping all relevant stakeholders informed of account status updates. Responsibilities include correcting discrepancies related to enrollment and cash posting within the billing process and preparing comprehensive documentation to communicate account issues to management, market groups, and regional personnel. Decisions made in this position typically involve interpreting area or departmental policies and selecting appropriate methods for completing assignments. The role operates within established parameters to ensure work expectations and quality standards are met, while allowing for some discretion regarding prioritization and timing. Although standard policies and practices are followed, the position provides opportunities for interpretation and independent judgment. Use your skills to make an impact

Requirements

• Minimum of 3 years’ experience in the healthcare industry, with a strong understanding of medical terminology.
• Proven background in medical billing, specifically as an HME/DME biller, and demonstrated experience in account reconciliation.
• Advanced analytical and problem-solving abilities, with a track record of successfully identifying and resolving account discrepancies.
• Proficient in Microsoft Excel and familiar with financial or billing software systems.
• Highly detail-oriented, with excellent organizational and time-management skills.
• Capable of working independently with minimal supervision, while effectively managing multiple priorities.
• Familiarity with Centers for Medicare and Medicaid Services (CMS) regulations is preferred.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Bilingual (Spanish speaker)

Nice To Haves

• 3 to 5 years of professional experience in a related field.
• Foundational knowledge of accounting principles and practices.
• Hands-on experience with medical coding, including proficiency in ICD-10.
• Billing and coding certification

Responsibilities

• Identifying and resolving discrepancies between company records and those maintained by the Centers for Medicare and Medicaid Services
• Performing monthly account reconciliations, thoroughly documenting any issues identified and developing actionable plans to resolve them
• Delivering exceptional customer service by keeping all relevant stakeholders informed of account status updates
• Correcting discrepancies related to enrollment and cash posting within the billing process
• Preparing comprehensive documentation to communicate account issues to management, market groups, and regional personnel

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees