Full Job Description
Responsibilities
The Claims Processing Representative 3 determines whether to return, deny, or pay claims following organizational policies and procedures. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.
Required Qualifications
High School Diploma
1 - 3 years of similar job experience
Proficiency in Microsoft Office Programs, including Word, PowerPoint, Excel
Strong data entry skills required
Previous experience in a healthcare or medical environment
Customer Service experience
Commitment to preserving confidentiality
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
MTV experience
CAS experience
Medical terminology, CPT-4 and ICD-9 coding & Medicare experience desired
Experience in medical claims processing
Additional information
Schedule:Monday to Friday 7:30 am to 4:30 pm
Training:1 month- remotely
Work Location (Address):Work at home from Puerto Rico ONLY
Limited Term (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
Scheduled Weekly Hours
40