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Humana

Claims Research & Resolution Representative 2

Humana, Trenton, New Jersey, United States

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Employer Industry: Healthcare Insurance Services

Why consider this job opportunity

Salary up to $52,300 per year

Opportunity for career advancement and growth within a Fortune 100 company

Flexible remote work opportunity

Comprehensive benefits package including medical, dental, and vision coverage, 401(k) plan, paid time off, and life insurance

Supportive work environment with a focus on associate engagement and well-being

Extensive training and professional development programs available

What to Expect (Job Responsibilities)

Manage inbound calls to address customer needs, including complex financial recovery and issue resolution

Document inquiries, comments, and transactions accurately, taking appropriate actions

Escalate unresolved customer inquiries to the appropriate departments

Interpret and apply department policies and procedures to complete assignments

Work independently within defined parameters while prioritizing and managing tasks

What is Required (Qualifications)

1 or more years of call center or telephonic customer service experience within the past 5 years

Previous healthcare-related experience or education

Basic skills in Microsoft Office (Word, Excel, Outlook, and Teams)

Strong technical skills with the ability to navigate multiple software systems

Demonstrated time management and prioritization skills, with the ability to maintain confidentiality while working remotely

How to Stand Out (Preferred Qualifications)

Bachelor's Degree

Prior experience in claims processing or financial recovery

Familiarity with Mentor software or CRM systems

Experience with PrePay or Post Pay processes

Knowledge of CAS, CIS, or CISPRO systems

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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.

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