Experienced Healthcare Insurance Eligibility Specialist - Remote Work Environment with Humana

Unlock a Rewarding Career in Healthcare with Humana

At Humana, we're passionate about improving the health and well-being of our members. As a leading healthcare company, we're dedicated to providing access to quality healthcare services and support to those who need it most. We're now seeking an experienced Healthcare Insurance Eligibility Specialist to join our team and play a vital role in ensuring our members receive the benefits they're entitled to.

About the Role

As a Healthcare Insurance Eligibility Specialist, you'll be the primary point of contact for verifying member eligibility and benefits. Your expertise will help us deliver exceptional customer service, ensure compliance with regulatory requirements, and drive the success of our team. If you're a detail-oriented professional with a passion for healthcare and excellent communication skills, we encourage you to apply.

Key Responsibilities

• Verify Member Eligibility: Accurately verify the eligibility of Humana members to ensure they have access to necessary healthcare services.
• Understand Insurance Processes: Utilize your knowledge of insurance eligibility and claims processes to verify member benefits and resolve any discrepancies.
• Communicate with Members: Effectively communicate with members to gather required information, explain their eligibility and benefits, and address any concerns.
• Collaborate with Team Members: Work closely with other team members to ensure timely and accurate verification of member eligibility.
• Maintain Documentation: Accurately document member eligibility and benefits verification for reference and auditing purposes.
• Stay Up-to-Date on Insurance Changes: Stay current with changes in insurance eligibility and benefits to ensure accurate verification for members.
• Provide Excellent Customer Service: Deliver exceptional customer service to members by addressing their questions and concerns regarding eligibility and benefits.
• Ensure Compliance: Ensure adherence to all regulatory and company policies and procedures related to verifying member eligibility.
• Handle Inquiries: Respond to inquiries from members, healthcare providers, and internal stakeholders regarding member eligibility and benefits.
• Contribute to Team Success: Meet individual and team goals related to member eligibility and benefits verification, driving overall team success.

Essential Qualifications

To excel in this role, you'll need:

• A strong understanding of insurance eligibility and claims processes.
• Excellent communication and interpersonal skills.
• Ability to work in a fast-paced environment and prioritize tasks effectively.
• Strong analytical and problem-solving skills.
• Proficiency in relevant software applications and systems.
• High school diploma or equivalent required; degree in a related field preferred.

Preferred Qualifications

While not required, the following qualifications will give you a competitive edge:

• Previous experience in healthcare insurance eligibility or a related field.
• Knowledge of healthcare industry regulations and compliance requirements.
• Certification in medical billing or insurance eligibility (e.g., CPC, CIC).
• Experience working in a remote or virtual environment.

Skills and Competencies

To succeed as a Healthcare Insurance Eligibility Specialist, you'll need:

• Strong attention to detail and organizational skills.
• Excellent customer service and communication skills.
• Ability to work independently and as part of a team.
• Analytical and problem-solving skills.
• Proficiency in relevant software applications and systems.
• Adaptability and flexibility in a fast-paced environment.

Career Growth Opportunities and Learning Benefits

At Humana, we're committed to helping you grow and develop in your career. As a Healthcare Insurance Eligibility Specialist, you'll have opportunities to:

• Develop your skills and expertise in healthcare insurance eligibility.
• Take on additional responsibilities and contribute to team success.
• Participate in training and development programs to enhance your knowledge and skills.
• Advance to leadership or specialized roles within the organization.

Work Environment and Company Culture

As a remote employee, you'll enjoy the flexibility and autonomy to work from anywhere. We're committed to creating an inclusive and supportive work environment that fosters collaboration, innovation, and growth. Our company culture values:

• Diversity, equity, and inclusion.
• Employee well-being and work-life balance.
• Continuous learning and development.
• Teamwork and collaboration.

Compensation, Perks, and Benefits

We offer a competitive salary and benefits package that includes:

• A comprehensive benefits program.
• Opportunities for professional growth and development.
• A dynamic and supportive work environment.
• Flexible work arrangements and remote work options.
• Recognition and rewards for outstanding performance.

Join Our Team

If you're a motivated and detail-oriented professional with a passion for healthcare, we encourage you to apply for this exciting opportunity. As a Healthcare Insurance Eligibility Specialist, you'll play a vital role in ensuring our members receive the benefits they're entitled to. Apply now and take the first step towards a rewarding career with Humana!

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.