Claims Consumer Experience Professional 2 Author by Humana

Profile

Description

Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a modern start-up and backed by the insights and scale of Humana, Author is pioneering a customer-centered experience designed to foster trusting relationships with members to help them achieve their best health.

Dedicated to simplifying the healthcare experience and helping people navigate their healthcare journey, Author is leveraging digital technologies to eliminate fragmentation and systematic friction for members and providers.

We are seeking individuals who are passionate about solving tough problems as we forge a new path for the healthcare industry. As a member of the Author team, you will have the opportunity to make a difference in the lives and health of the members we serve.

The Claims Research and Resolution Professional 2 will be part of a team of highly engaged individuals that manage claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. The Claims Research & Resolution Professional 2 work assignments involve moderately complex issues, where the analysis of situations or data requires an in-depth evaluation of various factors.

Responsibilities

Responsibilities


Help to create and maintain all associated Author Claims process workflows and standard operating procedures (SOPs)
Understand impacts on up/downstream Author/Humana Core processes
Learn Author and Humana Core claims processes as they relate to compliance timelines and key initiatives
Provide processing insight as it pertains to potential system fixes
Collaborate with other Author and Humana Core business teams to establish connections points
Work as a liaison between Author and Humana Core operations
Ensure accurate claims processing according to Author policies and procedures


Required Qualifications


Bachelor's degree or equivalent work experience
2 or more years of technical experience
Understanding of Claims processing
Strong communication skills
Excellent organizational skills
Must be driven to succeed with minimum supervision
Must be able to work as a team as well as individually


Preferred Qualifications


Masters degree
Ability to learn and teach others


Important Information Regarding COVID-19:

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. All necessary equipment and devises will be provided by Author by Humana.

Humana continues to monitor the situation and will adjust service levels as the coronavirus situation evolves. The changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and well-being during the hiring process.

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Scheduled Weekly Hours

40

Company info

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