Claims Research & Resolution Representative 2 jobs in United States
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Humana · 1 day ago

Claims Research & Resolution Representative 2

positionIdaho, United States
timeFull-time
remoteHybrid
seniorityEntry Level
money$40K/yr - $52K/yr
date1+ years exp

Humana is committed to putting health first for their teammates and customers. The Claims Research & Resolution Representative 2 manages claims operations involving customer contact, investigation, and resolution of claims or claims-related financial issues.

Health CareHealth InsuranceInsuranceVenture Capital
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H1B Sponsor Likelynote

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

Qualification

Call Center experienceHealthcare experienceMicrosoft Office skillsTechnical skillsTime managementSelf-reliancePrioritization skillsCRM experienceMentor softwareConfidentiality

Required

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

Preferred

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
Paid time off
Company and personal holidays
Volunteer time off
Paid parental and caregiver leave
Short-term and long-term disability
Life insurance

Company

Humana

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Humana is a health insurance provider for individuals, families, and businesses.
dateFounded in 1964
location
Louisville, Kentucky, USA
people-size10001+ employees
web-link
http://www.humana.com

H1B Sponsorship

Humana has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)

Funding

Current Stage
Public Company
Total Funding
$13.07B
2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B

Leadership Team

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Jim Rechtin
CEO and President
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Colin Drylie
Senior Vice President, Experience Transformation
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Recent News

Benzinga.com
House Passes Bill Extending Health Care Subsidies Despite GOP Leadership Opposition
2026-01-09
TradingView
Humana dips as Wells Fargo downgrades to "equal weight"
2026-01-07
PR Newswire
Leading Health Plans Become CAQH Owners to Shape the Future of Healthcare Data
2026-01-06
Company data provided by crunchbase