Claims Processing Representative
Humana is committed to putting health first and is seeking a Claims Processing Representative to join their team. The role involves reviewing and adjudicating complex claims, performing administrative tasks, and making decisions based on organizational policies and procedures.
Responsibilities
- Reviews and adjudicates complex or specialty claims, submitted either via paper or electronically
- Performs varied activities and moderately complex administrative/operational/customer support assignments
- Performs computations
- Determines whether to return, deny, or pay claims following organizational policies and procedures
- Works within defined parameters to identify work expectations and quality standards
- Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion
Skills
- MUST reside within 50 miles of the following Humana location: 101 E. Main St, Louisville, KY 40202
- Analytical thinking skills and comfortable working independently and with minimal supervision
- Prior experience working with multiple computer systems at a time and multitasking through those effectively
- Ability to manage multiple or competing priorities, including use of multiple computer applications simultaneously
- Excellent verbal and written communication skills
- Proficiency in all Microsoft Office: Word, PowerPoint, Excel
- 1+ years of experience within the healthcare and/or insurance industries
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- CAS Claims processing experience
- Bachelor's Degree
Benefits
- 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
Company Overview
Company H1B Sponsorship