Claims Research & Resolution Supervisor

Become a part of our caring community and help us put health first
 

As a Claims Research & Resolution Supervisor, you will manage claims operations that involve customer contact, investigation, and settlement of claims for and against our organization, including approval. Reporting to the Claims Research and Resolution Manager, you will follow established guidelines. You will apply independent judgment to analyze variable factors and resolve issues. Additionally, you will collaborate with management and specialists to select appropriate methods and analytical techniques.

The Claims Research & Resolution Supervisor will:

• Oversee approximately 14-18 direct reports

• Work with insurance companies, providers, members, and collection services in the settlement of claims.

• Manage a team comprised of a group of claims associates researching the resolution to a corrected claim.

• Make decisions that are typically related to schedules, plans and daily operations.

• Perform escalated or more complex similar work and manage a group of support and technical associates.

• Provide daily oversight to associates.

• Ensure consistency in execution across team.

• Hold team members accountable for following established policies.

Use your skills to make an impact
 

Required Qualifications:

• Minimum three (3) years of claims research and resolution experience

• Minimum two (2) years of team lead and/or management experience over direct reports, with demonstrated ability to develop associates through coaching and sharing feedback

• Proficiency with Microsoft Office programs including Outlook, Excel, Word and PowerPoint

• Experience managing multiple tasks, competing priorities and meeting deadlines.

Preferred Qualifications:

• Inventory Management Experience

Additional Information

Work-at-Home Information:

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

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

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

• Employees 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 employees 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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.

 

$65,000 - $88,600 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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.

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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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.