Claims Processing Representative 1/LT - Temporary position with Limited Benefits- Work at Home PR

Profile

Description

The Claims Processing Representative 1 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The Claims Processing Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.

Responsibilities

The Claims Processing Representative 1 determines whether to return, deny, or pay claims following organizational policies and procedures. Decisions are limited to defined parameters around work expectations, quality standards, priorities and timing, and works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation.

Required Qualifications

High School Diploma

1 year of similar job experience

Previous Medical Claims experience and / or knowledge of claims processes

Proficiency in all Microsoft Office Programs, including Word, PowerPoint, and Excel

Ability to manage multiple or competing priorities, work in a fast-paced environment and adapt quickly to change

Aptitude for quickly learning and navigating new technology systems and applications

Ability to think analytically

Strong focus on accuracy and detail

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Previous inbound call center or related customer service experience

Knowledge of HIPAA 837 and 835 electronic claims transactions

Knowledge of Medicare Risk Adjustment and/or Medicaid processes

Additional information

Limited Term Position (LT) : Associates with Humana may work any number of hours, depending on the business needs, for a limited time (usually 1 to 180 days). Benefits: Paid Time Off (PTO), Eligibility to participate in Humana's Partnership Savings Plan - Associates will be automatically enrolled in the 401K (accounts vest automatically on day one). Business Travel Accident Insurance. Associate Well-being Programs (WOW, EAP, Great Deals, Helping Hands, Giving Together, etc.). Reduced or Free Parking (depending on the geographic location) *Puerto Rico associates are not eligible to earn PTO but they will earn Vacation and Sick Time

Schedule: Monday to Friday from 7:30 am - 4:30 pm.

Training: 3-4 weeks via WebEx

Work Location (Address): Work At Home from Puerto Rico ONLY.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com