[Hiring] Claims Research and Resolution Professional @Humana

Role Description

The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against us. Approve all claim settlements both for and against us. The Claims Research & Resolution Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

• 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.
• Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.
• Occasionally in, and receive guidance where needed regarding own work methods.
• Follow established guidelines/procedures.

Qualifications

• Bachelor's degree
• Less than 5 years of technical experience
• Must be passionate about contributing to an organization focused on improving consumer experiences

Requirements

• Work at Home Requirements:
  • Self-provided internet service must meet a minimum download speed of 25 Mbps and an upload speed of 10 Mbps.
  • Wireless, wired cable or DSL connection is suggested.
  • Humana reserves the right to require associates to upgrade their internet service if necessary.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
• Scheduled Weekly Hours: 40
• Pay Range: $59,300 - $80,900 per year
• This job is eligible for a bonus incentive plan based on company and/or individual performance.

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Many other opportunities