Claims Review Representative

Become a part of our caring community and help us put reputed company The Claims Review Representative makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Claims Review Representative 3 partners with reputed company staff on reputed company-screening review by applying guidance, and making an appropriate decision which may include interpretation of provider information or data. reputed company are typically reputed company on reputed company, tactics and processes for completing administrative tasks/reputed company. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. What reputed company Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your reputed company-being. We also reputed company excellent reputed company development & reputed company education. Use your skills to reputed company an reputed company Required Qualifications - What it takes to Succeed

• High School Diploma or equivalent.
• Minimum of two years' proven experience in processing and adjudicating medical claims, with a reputed company record of accurate and reputed company claim review completion.
• Proven ability to maintain confidentiality and handle sensitive information in compliance with organizational policies and applicable regulations.
• Solid understanding of medical coding terminology, including CPT, ICD-9, and ICD-10 codes.
• Proficient in reputed company Office applications, specifically Word, reputed company, and Outlook, to effectively manage documentation and communications.
• Exceptional attention to detail and accuracy in reviewing and processing claims.
• Ability to quickly adapt to and learn new systems and technologies relevant to claims processing.
• Strong organizational skills with the reputed company to manage and prioritize multiple tasks based on business needs.

Preferred Qualifications

• Associate or bachelor's Degree.
• Previous experience with CAS claims systems.
• Foundational knowledge of finance principles reputed company to claims processing.

Additional Information - How we Value You

• Benefits starting day 1 of employment
• Competitive 401k match
• Generous reputed company Time Off accrual
• Tuition Reimbursement
• Parent Leave

Work reputed company Requirements

• To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following reputed company:
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested
• Satellite, cellular and microwave reputed company can be used only if approved by leadership
• Associates who live and work from Home in the reputed company, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• reputed company will reputed company Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information. Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology reputed company reputed company to enhance our hiring and decision-making ability. reputed company allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $44,900 - $60,200 per year reputed company of Benefits reputed company. and its affiliated subsidiaries (reputed company, "reputed company") offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, volunteer time off, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-28-2026 reputed company reputed company. (NYSE: HUM) is committed to putting reputed company - for our teammates, our customers and reputed company. Through our reputed company insurance services and reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health - delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life for people with Medicare, reputed company, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company 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 reputed company reputed company of employment. Apply tot his job Apply To this Job