Claims Research and Resolution Prof

Humana • Work at Home - Illinois, IL

8d • $59,300 - $80,900 • Remote

About The Position

The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against us. This role approves all claim settlements both for and against us. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Claims Research & Resolution Professional 2 works with insurance companies, providers, members, and collection services in the settlement of claims. This role is comprised of a group of calls/claims/provider associates researching the resolution to a pending call. The individual will understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Regarding own work methods, occasionally in, and and receive guidance where needed. Follow established guidelines/procedures.

Requirements

• Less than 5 years of technical experience
• Must be passionate about contributing to an organization focused on improving consumer experiences
• Self-provided internet service must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Bachelors Degree

Responsibilities

• Manages claims operations that involve customer contact, investigation, and settlement of claims for and against us.
• Approves all claim settlements both for and against us.
• Works with insurance companies, providers, members, and collection services in the settlement of claims.
• Researches the resolution to a pending call.
• Understands department, segment, and organizational strategy and operating goals, including their linkages to related areas.
• Follows established guidelines/procedures.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree