[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.

• The Claims Research & Resolution Professional 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.
• Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.
• Regarding own work methods, occasionally in, and receive guidance where needed.
• Follow established guidelines/procedures.

Qualifications

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

Requirements

• Bachelors Degree (Preferred).
• Work at Home Requirements:
  • Self-provided internet service must meet the following criteria:
    • Minimum download speed of 25 Mbps.
    • Minimum upload speed of 10 Mbps.
  • Wireless, wired cable or DSL connection is suggested.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Competitive benefits that support whole-person well-being.
• 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 and many other opportunities.

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$59,300 - $80,900 per year. This job is eligible for a bonus incentive plan based upon company and/or individual performance.