Humana

Claims Research & Resolution Professional

Humana
500 W Main St, Louisville, KY 40202, USA
Full-TimeDepends on ExperienceSenior LevelBachelors
Job Description

The Senior Claims Research & Resolution Professional works with operational teams, vendors, providers, and members in the processing of claims. Serves as a content model expert and mentor to teams regarding policies, procedures, and regulatory requirements. Strong analytical skills focusing on accuracy and attention to detail. Product knowledge and experience with claims review processes, clinical terminology, and regulatory requirements will be needed. Advises executives to develop functional strategies (often segment specific) on matters of significance.

Where is this job?
This job is located at 500 W Main St, Louisville, KY 40202, USA
Job Qualifications

  • 5 or more years of technical experience

  • Experience with Medicare claim inquiries

  • Experience in managed care or health care administration

  • Possess self-drive and strong initiative, able to work with minimal supervision/direction

Required Skills

  • Documentation

  • Vendor Management

  • Time Management

  • Data analysis and reporting skills

Soft Skills

  • Process Improvement

  • Verbal communication

  • written communication

  • Self-Driven

  • Detail Oriented and Organized

  • Multi-tasker

Compensation

According to JobzMall, the average salary range for a Claims Research & Resolution Professional in 500 W Main St, Louisville, KY 40202, USA is between $41,000 and $59,000 per year. This range may vary depending on company size, experience, location, and other variables.

Additional Information
Humana is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Required LanguagesEnglish
Job PostedDecember 9th, 2020
Apply BeforeJune 21st, 2025
This job posting is from a verified source. 
Reposted
See an issue with this job? Report it to us

Apply with Video Cover Letter Add a warm greeting to your application and stand out!

Upload
About Humana

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.

Frequently asked questions
More Jobs From Humana

View All Humana jobs

Get interviewed today!

JobzMall is the world‘ s largest video talent marketplace.It‘s ultrafast, fun, and human.

Get Started