Claims Research amp Resolution Representative 2 - Work At Home

Profile

Description

The Claims Research & Resolution Representative 2 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 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

The Claims Research & Resolution Representative 2 works with insurance companies, providers, members, and collection services in the settlement of claims.

Comprised of a group of calls/claims/provider associates researching the resolution to a pending call.

Decisions are typically focus on interpretation of area/department policy and methods for completing assignments.

Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.

Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Required Qualifications

Minimum 1 year of Call Center or related customer service experience

Capacity to maintain confidentiality

Must be passionate about contributing to an organization focused on continuously improving consumer experience.

Must be able to work any shift between the hours of 8am - 6pm EST (Monday - Friday)

T raining: Humana offers virtual training for the first 8 -10 weeks following start. Attendance is vital for your success. COME GROW WITH HUMANA! BENEFITS DAY ONE - STELLAR 401K MATCH - PAID TIME OFF - TUTION ASSISTANCE PROGRAMS - STELLAR WELLNESS/REWARDS PROGRAM Preferred Qualifications

Bachelor's Degree

Prior claims processing experience

MTV

PrePay or Post Pay experience

Overpayment experience Additional Information Work at Home Requirements

WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com