Claims Processing Representative

About the role

The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The role performs varied activities and moderately complex administrative/operational/customer support assignments. Responsibilities include determining whether to return, deny, or pay claims following organizational policies and procedures.

Responsibilities

• Determines whether to return, deny, or pay claims following organizational policies and procedures.
• Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing.
• Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Requirements

• MUST reside within 50 miles of the following Humana location: 101 E. Main St, Louisville, KY 40202.

Qualifications

• Analytical thinking skills and comfortable working independently and with minimal supervision.
• Prior experience working with multiple computer systems at a time and multitasking through those effectively.
• Able to manage multiple or competing priorities, including use of multiple computer applications simultaneously.
• Excellent verbal and written communication skills.
• Proficiency in all Microsoft Office: Word, PowerPoint, Excel.

Preferred Qualifications

• 1+ years of experience within the healthcare and/or insurance industries.
• Customer service experience.
• CAS Claims processing experience.
• Bachelor's Degree.

Skills

• Analytical thinking skills.
• Ability to manage multiple or competing priorities.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.
• Many other opportunities.

Pay

$40,000 - $52,300 per year

Schedule

This position is scheduled to start on Tuesday, September 8th, 2026. IN PERSON training starts day one of employment and will run for 6 weeks with a schedule of 8:00AM-4:30PM Eastern Monday - Friday. Work Schedule Following Training Following training and appraisal period, associates will transition to Work From Home and required to work a schedule of: 8:00AM-4:30PM Eastern Monday-Friday. The initial 120 days of employment constitute an appraisal period. This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.