Correspondence Representative

Humana-posted 8 months ago
$40,000 - $52,300/Yr
Full-time • Entry Level
Remote • Mansfield, TX
Insurance Carriers and Related Activities
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The Correspondence Representative 2 performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. Updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately.

  • Making reimbursement policy and process recommendations and ensures compliance with government regulations.
  • Analyzing provider reimbursement patterns and trends.
  • Making decisions that are typically focused on methods, tactics and processes for completing administrative tasks/projects.
  • Regularly exercising discretion and judgment in prioritizing requests, interpreting and adapting procedures, processes and techniques.
  • Working under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.
  • 1 or more years of claims experience
  • 1 or more years of Medicare and/or Medicaid experience
  • Minimum 1 year of technical experience (multiple system platforms and split screens simultaneously)
  • Proficiency with Microsoft office applications (Word, Excel, Outlook)
  • CAS experience
  • Claims processing experience
  • MHK knowledge
  • CRM knowledge
  • Medical, dental and vision benefits
  • 401(k) retirement savings plan
  • Paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave
  • Short-term and long-term disability
  • Life insurance
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