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The Bilingual Billing Reconciliation Representative 3 determines discrepancies between company records and the records of Center for Medicare and Medicaid Services. The Bilingual Billing Reconciliation Representative 3 performs advanced administrative / operational / customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

The Bilingual Billing Reconciliation Representative 3 reconciles accounts each month, documenting any problems found during reconciliation, and provides appropriate plans that will lead to their resolution. Provides exceptional customer service, ensuring that all interested parties are continually updated about the status of their account. Decisions are typically focused on methods, tactics, and processes for completing administrative tasks / projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques, and works under limited guidance due to previous experience, breadth, and depth of knowledge of administrative processes and organizational knowledge. The Bilingual Billing Reconciliation Representative 3 will support the associates, Team Lead (Rep 4), and Supervisor by performing a variety of tasks with moderate complexity.

Responsibilities

SME for all processes to include monitoring email and chats.

Train new associates and provide refresher courses.

Review processes and taglines for updates.

Submit tickets to CMS and monitor open tickets for completion.

Complete inventory and task assignments as requested to perform backup for Team Lead (Rep 4)

Use your skills to make an impact

Required Qualifications

1 or more years of customer service and / or administrative related experience

Must be Bilingual in Spanish / English (see Additional Information below)

Excellent verbal and written communication skills

Working knowledge of Microsoft Office applications (Word, Excel, PowerPoint, OneNote, Teams)

Intermediate mathematical skills

STRONG attention to detail

Must be able to work Eastern Time hours

Capacity to multi-task, including use of multiple computer applications simultaneously

Preferred Qualification

Knowledge in healthcare business applications and technology

1 - 3 years of technical experience

Less than 2 years of leadership experience; demonstrated capability with coaching and developing associates formally and informally

Applied knowledge of insurance processing, customer service and/or claims processes and practices

Experience with CI (Customer Interface)

Experience with EMME (Enterprise Messaging)

Experience with CRM

Required Work Schedule

Work hours are between 6:00 AM - 6:00 PM Eastern, Monday - Friday.

Associates typically work eight (8) hours per day. Associates may, within reason, choose their regular working hours / shift, if schedule is Monday - Friday and between the working hours specified above.

Overtime before / after hours and / or weekends may be offered, depending on business needs.

This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities outside of the Billing Reconciliation Department.

Additional Information

Please be advised, any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.  Candidates must be tested in ALL languages listed on the description.

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.

Satellite, cellular and microwave connection can be used only if approved by leadership.

Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Application Process

*PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) *  

Modern Hire Assessment

As part of our hiring process for this opportunity, we will be using technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. 

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$40,200 - $55,200 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.