Remote TRICARE Claims & Policy Specialist

Humana; Nashville (TN); Remote; USD 54,000 - 73,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Parental and caregiver leave

Disability insurance

Job summary

Humana, Inc. is seeking a Claims Process and Policy Professional 1 to handle TRICARE-related inquiries from beneficiaries, providers, and partners. You will research for accuracy, ensure completeness of responses, and collaborate with teammates to deliver precise answers.

This remote role supports the claims processing team and requires strong written and verbal communication, attention to detail, and a commitment to compliant service delivery.

Qualifications

• Experience communicating clearly and concisely to customer inquiries.
• Ability to present technical details to senior leadership.
• Experience with DoD contracts and TRICARE program rules.
• Must be a U.S. citizen eligible for government security clearance.

Responsibilities

• Identify root causes through the intake process and perform claims research.
• Implement improvements based on analysis and grow SME knowledge.
• Meet established expectations and drive results.
• Assist peers on complex issues and participate in required training.
• Demonstrate integrity and reliability, meeting commitments.

Skills

Communication skills

Written responses

Presentation skills

Team collaboration

Security clearance

Education

Bachelor's degree

Tools

SQL

Job description

Humana, Inc. is seeking a Claims Process and Policy Professional 1 to handle TRICARE-related inquiries from beneficiaries, providers, and partners. You will research for accuracy, ensure completeness of responses, and collaborate with teammates to deliver precise answers.

This remote role supports the claims processing team and requires strong written and verbal communication, attention to detail, and a commitment to compliant service delivery.