HCPR Reimbursement Claims Processing Representative - Remote

Overview

Become a part of our caring community and help us put health first. The Claims Processing Representative 2 adjudicates pharmacy claims and processes pharmacy claims for payment, performing varied activities and moderately complex administrative/operational/customer support assignments.

In Short

• Adjudicates pharmacy claims and processes claims for payment.
• Determines whether to return, deny, or pay claims according to policies.
• Involves outreach to members or pharmacies.
• Production-based expectations focused on efficiency and accuracy.
• Requires a rotating schedule of Monday-Friday and Tuesday-Saturday.
• Strong computer navigation and data entry skills required.
• 1-3 years of experience in healthcare or insurance industry preferred.
• Work at home requirements include specific internet speed.
• Occasional travel to Humana's offices for training may be required.
• Competitive benefits including medical, dental, and retirement plans.

Requirements

• High School Diploma or equivalent.
• 1-3 years of experience in the healthcare and/or insurance industry.
• Strong computer navigation and data entry skills.
• Customer service telephone experience preferred.
• Intermediate Microsoft application skills.
• Medical or pharmacy benefit claim processing experience is ideal.
• Previous employment with work at home background is a plus.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability.
• Life insurance and other opportunities.