Bilingual English/Spanish Claims Review Representative - Remote Puerto Rico - Sign On Bonus

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Job Information

Humana

Bilingual English/Spanish Claims Review Representative - Remote Puerto Rico - *Sign On Bonus*

in

San Juan

Puerto Rico

Description

This will be a great opportunity to showcase your ability to learn quickly and operate independently while supporting a high volume team that will count on your abilities to keep priorities moving forward.

The Claims Review Representative 1 makes appropriate claim decisions based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.

Responsibilities

The Claims Review Representative

Partners with professional staff on pre-screening review by applying guidance and making an appropriate decision which may include interpretation of provider information or data.

Decisions are limited to defined parameters around work expectations, quality standards, priorities and timing

Works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation

Hours will be Monday-Friday 8:00am-5:00pm

$1000 Sign-On Bonus ($300 upon hire, balance at completion of contract)

Position will be Limited Term contract of 6 months

Required Qualifications

Must reside in Puerto Rico

Bilingual English/Spanish with ability to pass a language assessment

2 years of Claims experience

Intermediate experience with CPT and ICD 10

Experience with basic administrative, clerical, customer support and/or computational tasks

Strong data entry skills

Computer proficiency in Microsoft Word and Excel

Preferred Qualifications

Associate's or Bachelor's Degree

Customer service experience

Experience using multiple computer applications simultaneously

Additional Information

For this job, associates are required to be fully COVID vaccinated, including booster (preferred) or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination, including booster  or commit to testing protocols OR  

Provide proof of applicable exemption including any required supporting documentation

​​Medical, religious, state and remote-only work exemptions are available.

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a SMS Text Messaging interview. You should anticipate this interview to take approximately 5-10 minutes.

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 of time. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following 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 wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

Company info

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