Humana Looking For Specialty Pharmacy Claims Representative at Cincinnati, OH Full Time

We are hiring a compassionate and empathetic individual with excellent customer service and communication skills to join our Patient Financial Services team!

The Pharmacy Claims Representative works to locate, obtain and maintain financial assistance for Humana Specialty Pharmacy patients. The Representative will handle inbound and outbound calls from patients and physicians to run and troubleshoot claims.

Responsibilities

The Pharmacy Claims Representative analyzes and answers inquiries regarding pharmacy claims adjudication, including method of payment, co-pay or deductible amounts, and/or reason for denial. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Required Qualifications

1+ years customer service experience

1+ years inbound/outbound call experience

Must be computer savvy with Windows operations experience

Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel and PowerPoint

Strong verbal and written communication skills, including the ability to tailor communication to audience

Must be able to demonstrate compassion and empathy for Humana Specialty Pharmacy users

Strong organizational and time management skills

Must be willing to be developed

Ability to handle multiple tasks, meet deadlines, and follow-up timely

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Previous experience with pharmacy benefits management

Claims experience

Pharmacy Tech experience

Case management skills

Additional Information

Remote work at home position in Ohio, Texas, Florida or Arizona. Will not consider candidates outside of these states.

Hours: Monday-Friday, 8 hour shift between 8am and 8pm EST. Mandatory OT required during peak season.

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

40