Correspondence Representative

Humana • Washington, DC

1d • $40,000 - $52,300 • Remote

About The Position

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. Ensure contracted rates and reimbursement policies are priced and applied accurately. You will report to the Supervisor, Claims Research & Resolution. As the Correspondence Representative 2 you will Make reimbursement policy and process recommendations and ensure compliance with government regulations Analyze provider reimbursement patterns and trends Use your skills to make an impact

Requirements

• 2 or more years of Customer Service and/or administrative experience (in past 5 years)
• 1 or more years of Healthcare claims experience
• Proficiency with Microsoft Outlook (email communication)
• 1 or more year of technical experience (multiple system platforms and split screens simultaneously)

Nice To Haves

• 1 or more years of Medicare and/or Medicaid experience
• Familiarity with MHK knowledge
• CAS experience
• Familiarity with CRM knowledge
• Experience with provider reimbursement policy analysis and documentation
• Knowledge of regulatory requirements and compliance standards for health insurance
• Microsoft Word (document creation) and Excel (formulas)

Responsibilities

• Make reimbursement policy and process recommendations and ensure compliance with government regulations
• Analyze provider reimbursement patterns and trends
• Research, analysis, documentation, and interpretation for the provider reimbursement programs
• Update, maintain, and review fee scheduling and pricing structures
• Ensure contracted rates and reimbursement policies are priced and applied accurately

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
• Education Level: No Education Listed