Humana

Bilingual Consumer Service Experience Representative III

Florida, United States

Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

Candidates must be bilingual in English and Spanish with the ability to read, write, and speak fluently without limitations or assistance, possessing a minimum of one year of customer service experience in a healthcare setting, and proficient in Microsoft Office, Outlook, Word, and Excel. They must also demonstrate an aptitude for quickly learning new technology and systems, and have working knowledge of computers, along with a passion for improving consumer experiences. Previous healthcare experience, a clerical support background, familiarity with medical terminology, and a CNA or Medical Assistant background are preferred.

Responsibilities

The Bilingual Consumer Service Operations Representative III will perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations, investigating and settling claims and customer service issues. This individual will regularly exercise discretion and judgment in prioritizing requests and adapting procedures, processes, and techniques, working under limited guidance due to previous experience and organizational knowledge. They may also apply intermediate mathematical skills and travel between five different locations in Miami, Miami Beach, and Pembroke Pines to provide services.

Skills

Bilingual English/Spanish
Customer Service
Healthcare Support
Microsoft Office
Outlook
Word
Excel
Communication Skills
Technology Navigation

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Key Metrics

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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