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Claims Research & Resolution Representative

Remote / Online - Candidates ideally in
Missouri, USA
Listing for: Humana
Remote/Work from Home position
Listed on 2026-01-13
Job specializations:
  • Customer Service/HelpDesk
    HelpDesk/Support, Technical Support
Salary/Wage Range or Industry Benchmark: 52300 USD Yearly USD 52300.00 YEAR
Job Description & How to Apply Below
Position: Claims Research & Resolution Representative 2

Employer Industry: Health Insurance Services

Why consider this job opportunity
  • Salary up to $52,300 per year
  • Opportunity for career advancement and growth within the organization
  • Work remotely from the comfort of your home
  • Comprehensive benefits package including medical, dental, vision, and 401(k) retirement savings plan
  • Supportive and collaborative work environment that values associate engagement and well‑being
  • Virtual training and professional development opportunities provided from day one
What to Expect (Job Responsibilities)
  • Manage inbound calls to address customer needs, including complex financial recovery and issue resolution
  • Record detailed notes of inquiries, comments, and transactions, taking appropriate action
  • Escalate unresolved customer inquiries and issues to the appropriate departments
  • Interpret departmental policies and methods to complete assignments effectively
  • Work independently while following defined parameters and quality standards
What is Required (Qualifications)
  • 1 or more years of call center or telephonic customer service experience within the past 5 years
  • Previous healthcare‑related experience or education
  • Basic proficiency in Microsoft Office (Word, Excel, Outlook, and Teams)
  • Strong technical skills to work across multiple software systems
  • Ability to manage multiple priorities and maintain confidentiality while working remotely
How to Stand Out (Preferred Qualifications)
  • Bachelor's degree
  • Prior claims processing experience
  • Experience with financial recovery and over payment issues
  • Familiarity with Mentor software
  • Experience in Pre Pay or Post Pay processes

#Health Insurance #Customer Service #Remote Work #Career Growth #Employee Benefits

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Our role in this specific opportunity is to connect outstanding candidates with a top‑tier employer.

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