Consumer Service Operations Professional 1 - Remote

Overview

Become a part of our caring community and help us put health first. You will perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations.

In Short

• Research customer inquiries to resolve claims issues.
• Document and track issues relating to financial, system and beneficiary data.
• Coordinate and present research findings to internal and external customers.
• Make recommendations based on root cause analysis.
• Perform client support and customer service duties.
• Investigate and settle claims and customer service issues.
• Work from home with specific internet requirements.
• Occasional travel to Humana's offices for training or meetings may be required.
• Full-time position with a pay range of $45,400 - $61,300 per year.
• Competitive benefits including medical, dental, and vision.

Requirements

• U.S. citizenship required for Department of Defense Contract.
• 3 years of experience in managed care environment.
• 3 years of claims experience processing/adjudicating claims.
• Experience with TRICARE contracts or military health care delivery system.
• 2 years of customer service experience.
• Familiarity with reimbursement terminology (DME, DRG, HCPCS, CPT coding).
• Ability to work from a dedicated space without interruptions.
• Meet internet connection requirements for remote work.
• Ability to receive interim approval for government security clearance.
• Not authorized to work in Puerto Rico.

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.