Consumer Service Operations Professional WAH Nationwide

Profile

Description

The Consumer Service Operations Professional 1 is responsible for the daily activities across multiple service functions area. The Consumer Service Operations Professional 1 work assignments are often straightforward and of moderate complexity.

Responsibilities

Humana is seeking a Consumer Service Operations Professional 1 who may perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. This position investigates and settles claims and customer service issues. They will understand their own work area professional concepts/standards, regulations, strategies and operating standards. This individual makes decisions regarding own work approach/priorities, and follows direction. Their work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

Typical responsibilities of this position include:


supporting member/provider experience design
investigating and settling claims and customer service issues
identifying automation/optimization opportunities/development of reporting
quality assurance/creation and driving IT projects


Required Qualifications


Bachelor's degree or 3 years working experience in a service operations environment equivalency
Ability to manage multiple or competing priorities and work in a very fast-paced environment
Strong written and verbal communication skills
1 years Customer Service experience
Comprehensive knowledge of Microsoft Office Suite to include Word, Excel, PowerPoint and Access are a plus
Investigative and problem solving skills
Organizational skills and an ability to manage multiple, shifting priorities, and meet deadlines in a fast paced environment
Ability to analyze information, research problems, and determine and implement solutions
Must have accessibility to high speed DSL or cable modem for a home office (satellite internet service is NOT allowed for this role); and a minimum internet connection speed of 10M x 1M
A dedicated home office space, with a locked door, lacking ongoing interruptions to protect member PHI / HIPAA information
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


Experience with medical claims/health insurance
Previous letter writing experience
Knowledge of health insurance compliance impacts
Previous Team Lead experience


Additional Information

Must have accessibility to high speed DSL or cable modem for a home office (satellite internet service is NOT allowed for this role); and a minimum internet connection speed of 10M x 1M

Scheduled Weekly Hours

40

Company info

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