[Remote] Billing and Enrollment Representative at Humana

Wisconsin, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

1+ years of experience in Accounts Receivables, Billing or Collections
Demonstrated Excel skills for data submission, filtering, sorting, etc
Passionate about contributing to an organization focused on continuously improving consumer experiences
Ability to work during core business hours of 8:00am to 4:30pm CST, Monday through Friday
Self-provided internet service meeting minimum speeds (25 Mbps download, 10 Mbps upload); wireless, wired cable or DSL suggested (satellite, cellular, microwave only if approved)
Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information

Responsibilities

Determine financial obligations towards room and board costs for iCare and Inclusa members
Enter and generate invoices for member financial obligations towards room and board, cost share or patient liability, as determined by county Income Maintenance consortiums, in compliance with contract requirements for long-term care Medicaid waiver programs
Apply member payments and reconcile accounts each month
Document problems found during reconciliation and provide follow-up, including collection activities for past due balances, to lead to resolution
Provide exceptional customer service, ensuring all interested parties are continually updated about account status
Correct and/or update invoice amounts based on reported changes or cost share reports from the Wisconsin Department of Health Services
Document collection efforts and reported changes impacting member billing
Perform advanced administrative/operational/customer support duties requiring independent initiative and judgment
Apply intermediate mathematical skills
Prepare documents to inform management, internal parties, and external stakeholders of account issue status
Exercise discretion and judgment in prioritizing requests, interpreting and adapting procedures, processes, and techniques, working under limited guidance

Skills

Key technologies and capabilities for this role

Accounts ReceivableBillingInvoice GenerationAccount ReconciliationCollectionsCustomer ServiceMedicaidAdministrative Support

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.

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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