WI Medicaid FC Claims Rep 3

Humana

1d • Remote

About The Position

Become a part of our caring community and help us put health first The Claims Research & Resolution Representative 3 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for and against the organization. The Claims Research & Resolution Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. The Claims Research & Resolution Representative 3 works with insurance companies, providers and internal resources to validate and audit claims payments, request refunds for overpayments and work with claims vendor to offset payments. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. Use your skills to make an impact

Requirements

• 1 - 3 years of claims experience in a health care or equivalent setting
• Proficient in Microsoft applications
• Effective communication
• Attention to detail
• Capacity to maintain confidentiality
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Nice To Haves

• Bachelor's Degree
• Prior auditing experience

Benefits

• Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being.
• Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
• Among our 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
• Number of Employees: 5,001-10,000 employees