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

• 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, and works under minimal direction.
• 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

Use Your Skills To Make An Impact

Benefits

• Work 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.
• 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.
• The department has a strict attendance policy. Time off is not permitted during the first 90 days and is discouraged during the 120-day appraisal period.
• This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities.

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.