Medical Claims Processing Representative 2

Profile

Job Information
Humana
Medical Claims Processing Representative 2
in
Jersey City
New Jersey
Description
The Medical Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically.
How we Value You
Benefits starting day 1 of employment
Competitive 401k match
Generous Paid Time Off accrual
Tuition Reimbursement
Parent Leave
Go365 perks for well-being
Responsibilities
Medical Claims Processing Representative 2
Determines whether to return, deny, or pay claims following organizational policies and procedures
Focus on claims, type of claim, ERT, resources and process guide
Metric processing around 40 claims on hour
Required Qualifications
1 or more years of Medical Claims Processing, Medical Coding/Billing, Customer Service and/or Provider Customer Service experience
Working knowledge of Word, Excel, and Outlook
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Associates Degree
Quality background
Bilingual English/Spanish with ability to pass a Language Assessment
Additional Information
Monday - Friday 8:00 AM to 5:00 PM EST with ability to support business as needed for overtime as needed. Leader will discuss during the interview
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 pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Work-At-Home Requirements
WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
Internal-
If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

Company info

Sign Up Now - BilingualCrossing.com