[Remote] Consumer Experience Professional at Humana

Kentucky, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

4+ years of customer service experience
Experience with Microsoft Word and Excel
Experience in a Production-driven environment
Written correspondence/professional writing experience
Strong verbal communication skills
Strong investigative skills
Excellent time management skills
Preferred Qualifications
Bachelor's Degree
Prior experience with complaint or appeals handling
Previous experience processing medical claims
Bilingual (English and Spanish); with the ability to read, write, and speak English and Spanish
1+ year of experience with escalated customer service inquiries

Responsibilities

Investigates and responds to escalations on behalf of Senior Leaders
Oversees the entire process, ensures that all root causes are identified and remediated, and provides clear and complete resolution for every escalation
Works functionally across the organization to review and resolve issues and pain points
Establishes and maintains strong internal and external relationships

Skills

Key technologies and capabilities for this role

Microsoft WordMicrosoft ExcelCustomer ServiceInvestigative SkillsProfessional WritingVerbal CommunicationTime ManagementComplaint HandlingAppeals HandlingMedical Claims Processing

Questions & Answers

Common questions about this position

Is this position remote or work from home?

Yes, this is a work-at-home or hybrid home/office position with specific internet speed requirements (minimum 25 Mbps download and 10 Mbps upload) and a dedicated workspace to protect PHI/HIPAA information. Humana provides telephone equipment but generally does not reimburse internet costs except in certain states like California, Illinois, Montana, or South Dakota.

What are the required qualifications for this role?

Required qualifications include 4+ years of customer service experience, experience with Microsoft Word and Excel, experience in a production-driven environment, written correspondence/professional writing experience, strong verbal communication skills, strong investigative skills, and excellent time management skills.

What is the salary or compensation for this position?

This information is not specified in the job description.

What preferred qualifications would make me stand out?

Preferred qualifications include a Bachelor's Degree, prior experience with complaint or appeals handling, previous experience processing medical claims, bilingual skills in English and Spanish, and 1+ year of experience with escalated customer service inquiries.

What should I know about the application process?

Include your resume with your application, as the position is on EST and uses HireVue interviewing technology for enhanced decision-making if selected to move forward.

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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