Claims Processing Representative 2

Humana Inc. • San Juan, PR

40d • Remote

About The Position

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. 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.

Requirements

• MUST reside within 50 miles (80.5 km) of the following Humana location: 383 Ave Fd Roosevelt, San Juan, PR 00918, Puerto Rico
• 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

Nice To Haves

• 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

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
• Industry: Insurance Carriers and Related Activities
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees