Pharmacy Claims Representative 2 – Patient Financial Services

🔥 2 hours ago

🌵 Arizona, Ohio – Remote

🌵 Arizona – Remote 🏈 Ohio – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Adjudicate and process pharmacy claims for payment • Analyze and answer inquiries regarding pharmacy claims adjudication, including payment method, co-pay or deductible amounts, and reasons for denial • Analyze data and provide financial support • Develop relationships with foundations and manufacturers on behalf of CenterWell Specialty Pharmacy customers • Provide internal customer support for the entire Pharmacy • Source patient assistance programs and/or foundations to help patients meet out-of-pocket responsibilities • Make inbound and outbound calls regarding patient assistance programs, billing inquiries, and insurance verification • Provide internal and external customer service • Document case files with complete notes • Complete special projects with varied and complex components as needed

🎯 Requirements

• 1 or more years of customer service experience handling both incoming and outgoing phone calls in a professional setting • Comprehensive knowledge of Microsoft Products including Word, Excel and Outlook • Intermediate to High level of Windows Based system navigation • Must be able to work an 8 hour shift between 8am and 8pm EST Monday-Friday • Overtime may be required during peak season • Minimum internet speed of 25 Mbps download and 10 Mbps upload • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

🏖️ Benefits

• Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Remote work arrangement • Home internet requirements/support for effective work • Occasional travel to Humana offices for training or meetings may be required