[Remote] Consumer Service Operations Representative III at Humana

Florida, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Candidates must be able and willing to travel between three different locations in Jupiter, Palm Beach Gardens, and West Palm Beach, Florida, and possess at least one year of customer service experience in a healthcare setting. Proficiency in Microsoft Office Suite (Outlook, Word, Excel) and excellent verbal, listening, and written communication skills are required, along with an aptitude for quickly learning new technology and systems.

Responsibilities

The Consumer Service Operations Representative 3 is responsible for daily activities across multiple service functions, performing advanced administrative and operational duties that require independent initiative and judgment. This role involves investigating and settling claims and customer service issues, and may include tasks related to installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations.

Skills

Customer Service

Healthcare

Microsoft Office

Outlook

Word

Excel

Communication

Technology Navigation

Computer Proficiency

Claims Processing

Enrollment

Eligibility

Call Center Operations

Administrative Support

Clerical 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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