Customer Connection Specialist

Be a part of the Provider Network Operations world — collaborate cross functionally to identify process opportunities to improve the provider experience.

Humana is seeking a Customer Connection Specialist, you will: handle incoming calls from providers, members, markets, Humana affiliates and internal Humana associates on an 800 line to assess the validity of overpaid claims and assist providers in resolving patient accounts. You will proactively identify and evaluate problems, identify appropriate subject matter experts to solve them, and draw conclusions from the information you collect.

Respond to, process, resolve and provide information for transactions, inquiries and complaints to and for customers

Post overpayment refunds and establish initial setups using the Financial Recovery System, MetaVance and Bader

Utilize the concepts of retro terminations, provider deductions, general overpayments, check reconciliation, subrogation recoveries, stop payments and returned checks to resolve problems

Allocate refunds to the financial recovery system, adjudicate financial recovery pends and maintain standards of production to meet Financial Recovery Department goals

Qualifications

Role Essentials

High School Diploma

Prior customer service experience

Comprehensive knowledge of Microsoft Word, Access and Excel

Ability to toggle between multiple systems while documenting notes and communicating with the customer

Role Desirables

Associate’s or Bachelor’s Degree of Art or Science

Claims processing experience

Call center experience

Ability to multi-task at high level

Reporting Relationships

You will report to a Frontline Leader. This area is under the leadership of the SVP & Chief Operating Officer.

Additional Information

At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.

Schedule

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Full-time

Primary Location

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US-KY-Louisville

Role

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Provider Network Operations

Work Environment Type

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Office