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The Medicaid Billing Reconciliation & Enrollment Representative 3 is responsible for the accurate enrollment and billing process for an insurance organization. The Medicaid Billing Reconciliation & Enrollment Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

               

Looking for a solid career opportunity? The Medicaid Billing Reconciliation & Enrollment Representative 3 maintains related documents, updates corresponding records, and is responsible for enrollment and billing queries. May be responsible for or assist in addressing broad, complex enrollment and billing issues. Decisions are typically focused on methods, tactics, and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques. Works under limited guidance utilizing previous experience and breadth / depth of knowledge of administrative processes and organizational operations.

Use your skills to make an impact
 

Location

This is a remote position but located within a specific geography

• MUST CURRENTLY RESIDE IN THE STATE OF OKLAHOMA

Required Work Schedule

• Virtual Training will start day one of employment and runs the first 3 to 5 weeks with a schedule of 8:00 am – 4:30 pm EST, Monday - Friday.
• You must be on camera / camera ready during training and for other meetings required by leadership.
• Attendance is vital for success, so no time off is allowed during training or within your first 120 days, with the exception of observed (and paid) company holidays. 
• Following training, must be available to work an 8-hour shift between the hours of 6:00 am – 5:30 pm EST, Monday – Friday (subject to change based on business needs).
• Some weekends and overtime may also be required, depending on business needs.  We strive to provide a minimum of a week’s advance notice for weekends and overtime.
• The initial 120 days of employment as Medicaid Billing Reconciliation & Enrollment Representative 3 constitute an appraisal period.  This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.
• This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role.  You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities outside the Oklahoma Medicaid Billing Reconciliation & Enrollment Team.

Required Qualifications

• Must currently reside in the state of Oklahoma
• Previous experience in a metrics-driven production environment
• One year Intermediate level experience with Microsoft Word and Excel
• Strong experience in interpreting and entering data
• Effective research ability to organize and resolve inquiries in timely fashion by using best practices
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Healthcare experience
• Intermediate mathematical skills
• Experience with CI (Customer Interface), AE (Automated Enrollment) and MACESS
• Experience utilizing Enterprise Messaging (EMME)
• 1+ years’ experience with CRM

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Additional Information

**PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT)** 

Modern Hire Assessment

As part of our hiring process for this opportunity, we will be using a technology called Modern Hire to enhance our hiring and decision-ma