Become a part of our caring community and help us put health first
The Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area. The Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.
The Bilingual Consumer Service Operations Representative III may perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. This individual investigates and settles claims and customer service issues. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. This individual 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.
Responsibilities include:
- Role will expand to project specialist with responsibility to sustain customer service levels by providing center coverage for associates on PTO or during new hire recruiting/training.
- Requires working closely with administrators and medical staff to analyze, disseminate and improve patient experience outcomes and acting as liaison between provider contracting, Market agents and Market leaders.
- Assist Market agents and leaders with escalated member issues.
- Coordinate participation in Market member orientations.
- Identify and analyze trends and insights in assigned Market.
- Work closely with provider administrators on their CAHPS and HOS surveys.
- Conduct, coordinate and schedule In-Services for new centers and existing rotations as required.
Use your skills to make an impact
Required Qualifications
- Bilingual English/Spanish: ability to read, write, speak fluently without limitations or assistance
- Minimum of 1 year of customer service experience in a healthcare setting
- Proficient in Microsoft Office, Outlook, Word, and Excel
- Excellent verbal, listening and written communication skills
- Aptitude for quickly learning and navigating new technology, systems and applications as well as working knowledge of computers
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Work-At-Home Requirements
- 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
Preferred Qualifications
- Undergraduate Degree
- Previous healthcare experience
- Clerical support background in a healthcare environment
- Familiarity with medical terminology and/or ICD-10 codes
- CNA or Medical Assistant background
- Quality background
- Medicare experience
Additional Information
- As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling, and Video technologies allow you to interact with us at the time and location most convenient for you.
- If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
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 veteran status. 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.
