[Remote] BILINGUAL Claims Research & Resolution Rep 2

Note: The job is a remote job and is open to candidates in USA. Humana is a Fortune 100 company committed to putting health first for its customers and teammates. The Bilingual Claims Research & Resolution Representative 2 manages claims operations involving customer contact and resolution of claims-related issues, working remotely to utilize research and customer service skills.

Responsibilities

• Taking inbound calls to address customer needs which may include complex financial recovery, answering questions, and resolving issues.
• Recording notes with details of inquiries, comments or complaints, transactions or interactions and taking action accordingly.
• Escalation of unresolved and pending customer inquiries.
• Decisions are typically focused on interpretation of area or department policy and methods for completing assignments.
• Standard policies and practices allow for some opportunity for interpretation / deviation and / or independent discretion. Work is within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization and timing, and works under minimal direction.

Skills

• Bilingual (Spanish / English) (see Language Proficiency Testing below)
• 1 or more years of Call Center or Telephonic customer service experience (within the past 5 years)
• Previous healthcare related experience or education
• Basic Microsoft Office (Word, Excel, Outlook, and Teams) skills
• Strong technical skills with the ability to work across multiple software systems
• Self-reliance with the ability to resolve issues independently with minimum supervision
• Ability to use internal system resources (i.e., Mentor) to find a resolution to an issue and/or respond to an inquiry
• Demonstrated time management and prioritization skills
• Ability to manage multiple or competing priorities
• Capacity to maintain confidentiality working remotely out of your home
• Bachelor's Degree
• Prior claims processing experience
• Overpayment experience
• Financial recovery experience
• Previous experience with Mentor software
• PrePay or Post Pay experience
• CAS, CIS or CISPRO experience
• CRM experience

Benefits

• 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

Company Overview

Company H1B Sponsorship