Humana

Claims Representative 2

Milwaukee, WI Full time

Become a part of our caring community and help us put health first
 

Are you ready to make a meaningful impact in the world of healthcare claims? As a Claims Representative 2, you will play a vital role in collaborating with insurance companies, healthcare providers, members, and collection services to resolve and settle claims. This position offers the opportunity to join a dedicated team focused on researching pending claims and ensuring timely, accurate resolutions. If you are looking for a challenging and rewarding role that values analytical thinking and effective communication, we invite you to explore this exciting opportunity.

Key Responsibilities:

  • Works with insurance companies, providers, members, and collection services in the settlement of claims
  • Reviewing pended claims and making determinations on how the claim should be handled
  • Provide general office support to the Operations Department- printing, sorting, mailing, scanning, etc.
  • Creating claims reports and submitting for adjustments
  • Cross trained in multiple areas within the Claims Department
  • Review and update internal policies and procedures as needed
  • Provide audit support as needed


Use your skills to make an impact
 

Required Qualifications
  • 1 year of claims experience

  • Previous call center or related customer service experience

  • Capacity to maintain confidentiality

  • Proficiency in Microsoft Office applications

  • Effective communication skills

  • Must be able to work within the Milwaukee River Center office location at least 3 days per week

Preferred Qualifications

  • Associates degree in related field

  • QNXT experience

Additional information:

  • Hybrid Office: The Humana office is an associate's primary work location where the majority of their work week will be spent, but they will work occasionally from home to support focus work and work/life balance needs.

  • Typical work days/hours: Full time - 8am-4:30pm CST, Monday - Friday

WAH Internet Statement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

  • Satellite, cellular and microwave connection can be used only if approved by leadership.

  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

SSN Alert

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


 

$40,000 - $52,300 per year


 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.


About Us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.