Claims Research & Resolution Rep

Humana • Carapichaima, IN

2d • Remote

About The Position

The Claims Research & Resolution Representative 2 manages claims operations that involve customer contact, investigation, and resolution of claims or claims-related financial issues. You will perform moderately complex call center, administrative, operational and customer support assignments. Workload is typically semi-routine assignments along with intermediate level math computations. This is an opportunity to work remotely and use your research, resolution and customer service skills to join a Fortune 100 company with a great culture and outstanding benefits. Humana values associate engagement and well-being. We also provide excellent professional development and continued education. The Claims inbound call center is comprised of a group of calls / claims / provider associates researching the resolution to a pending call. As a Claims Research & Resolution Representative 2, you will work with insurance companies, providers, members, and collection services in the resolution of claims.

Requirements

• 1 or more years of Call Center or Telephonic customer service experience (within the past 5 years)
• Previous healthcare related experience or education
• Basic Microsoft Office (Word, Excel, Outlook, and Teams) skills
• Strong technical skills with the ability to work across multiple software systems
• Self-reliant, with the ability to resolve issues independently under minimum supervision
• Ability to use internal system resources (i.e., Mentor) to find a resolution to an issue and / or respond to an inquiry
• Demonstrated time management and prioritization skills
• Experience managing multiple or competing priorities
• Capacity to maintain confidentiality while working remotely out of your home

Nice To Haves

• Bachelor's Degree
• Prior claims processing experience
• Overpayment experience
• Financial recovery experience
• Previous experience with Mentor software
• PrePay or Post Pay experience
• CAS, CIS or CISPRO experience
• CRM experience

Responsibilities

• Take inbound calls to address customer needs which may include complex financial recovery, answering questions, and resolving issues.
• Potentially making outbound calls regarding case follow-up.
• Record notes with details of inquiries, comments or complaints, transactions or interactions and taking action accordingly.
• Escalate unresolved and pending customer inquiries.
• Cross-train in all functions within the department.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level