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Humana

Claims Research & Resolution Representative 2

Humana, New York, New York, us, 10261

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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 the organization

Work remotely, offering flexibility and a better work-life balance

Comprehensive benefits package including medical, dental, vision, and a 401(k) retirement savings plan

Commitment to associate engagement and well-being, with professional development and continuing education opportunities

Supportive work environment that encourages personal wellness and smart healthcare decisions

What to Expect (Job Responsibilities)

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

Record detailed notes of inquiries, comments, complaints, and interactions, and take appropriate action

Escalate unresolved customer inquiries and pending issues as necessary

Interpret department policies and methods for completing assignments, making decisions within established parameters

Maintain confidentiality while working remotely and manage multiple priorities

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 Suite (Word, Excel, Outlook, and Teams)

Strong technical skills with the ability to navigate multiple software systems

Ability to resolve issues independently with minimal supervision How to Stand Out (Preferred Qualifications)

Bachelor's degree

Prior claims processing experience

Experience with financial recovery and overpayment resolution

Familiarity with Mentor software or similar systems

Experience in PrePay or Post Pay claims processing

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. 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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