Ilr Claims Representative Jobs (NOW HIRING)

Become a part of our caring community
The Billing & Reconciliation Representative 2 determines discrepancies between company records and the records of Center for Medicare and Medicaid Services. You will perform varied assignments. activities and moderately complex administrative/operational/customer support.

• Reconcile accounts each month, documenting any problems found during reconciliation, and provide appropriate plans to lead to their resolution.
• Update all interested parties continually about the status of their account, providing exceptional customer service.
• Correct enrollment and cash posting discrepancies as they relate to billing.
• Prepare documents to inform management, market groups, and regional personnel of the status of account issues.
• Decisions typically focus on interpretation of area/department policy and methods for completing assignments.
• Work within defined parameters to identify work expectations and quality standards, but have some latitude over prioritization/timing, and works under minimal direction.
• Follow standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Use your skills to make an impact
Required Qualifications

• Bilingual (English and Spanish); with the ability to read, write, and speak in both languages with no limitations or assistance (See, Additional information for language assessment information).
• One (1) or more years of healthcare billing, accounts receivable, revenue cycle, or reconciliation experience.
• Experience with payment posting and account reconciliation.
• Proficiency in Microsoft Office, specifically Excel.
• Knowledge of insurance claims processing, including Medicare, Medicaid, and commercial payers.
• Knowledge of ICD-10, and HCPCS coding concepts.

Additional Information

• Workstyle: This is an Office-based position in Humana's One Homecare Solutions location in Miramar, FL.
• Work Schedule: Monday - Friday; 8:00am - 5:00pm Eastern Time (ET).
• Language Proficiency Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

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.
$40,000 - $52,300 per year
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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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.