Remote Senior Claims Research & Reimbursement Professional

Humana; Montgomery (AL); On-site; USD 59,000 - 81,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana is seeking a Senior Claims Research & Resolution Professional to manage complex claims inquiries, investigations, and resolutions across multiple business areas. The role involves analyzing data, identifying trends, and collaborating with internal partners to ensure accurate adjustments.

Responsibilities include mentoring teammates, leading projects, and supporting SAS/CAS/CIS environments. Remote role with occasional travel; 40 hours weekly; pay range listed with bonus eligibility.

Qualifications

• Minimum 3 years claims research and/or processing experience with CAS.
• Minimum 3 years Mentor experience reviewing Claims processing documents.
• Minimum 3 years CIS/CIS Pro experience.
• Minimum 2 years experience with Medicaid claims.
• Minimum 2 years project leadership experience.
• Experience utilizing data analysis tools to review, interpret, and identify trends in claims data.

Skills

Claims research

Mentor experience

CIS/CIS Pro

Medicaid claims

Project leadership

Data analysis tools

Job description

Humana is seeking a Senior Claims Research & Resolution Professional to manage complex claims inquiries, investigations, and resolutions across multiple business areas. The role involves analyzing data, identifying trends, and collaborating with internal partners to ensure accurate adjustments.

Responsibilities include mentoring teammates, leading projects, and supporting SAS/CAS/CIS environments. Remote role with occasional travel; 40 hours weekly; pay range listed with bonus eligibility.