Become a part of our caring community and help us put health first
 

Humana Healthy Horizons in Ohio is seeking a Consumer Service Operations Professional 2 who is responsible for the daily activities across multiple service functions area. The Consumer Service Operations Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

You will be part of a caring community at Humana.
When you meet us, you can tell we started as a hometown company. We’re proud of our Louisville roots and, as we’ve grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you’re working from home, from the field, from our offices, or from somewhere in between—you’ll feel welcome here. We’re a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It’s up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve.

Are you Caring, Curious and Committed? If so, apply today!

The Consumer Service Operations Professional 2:

• Member support, customer service, enrollment, and eligibility, claims review and research, and call center operations
• Investigates and settles claims and customer service issues
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
• Follows established guidelines/procedures

 

This is a remote position.

Use your skills to make an impact
 

Required Qualifications

• Must reside in Ohio
• 2 or more years experience in a service operations environment
• Prior claims experience
• Demonstrated ability to analyze information, research problems, and determine and implement solutions
• Ability to manage multiple or competing priorities and work in a very fast-paced environment
• Strong written and verbal communication skills to include presentation skills
• Excellent interpersonal skills and ability to develop collaborative working relationships across multiple functional areas in the organization or with consumers
• Consultative skills which include ability to assess, understand the consumer and make recommendations
• Ability to work independently
• Comprehensive knowledge of Microsoft Office Suite to include Word, Excel, PowerPoint and Access
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Bachelor's Degree
• Organizational skills necessary to effectively manage multiple activities
• Experience with medical claims/health insurance
• Project Management experience

Additional Information

About Humana

Your growth is what drives Humana forward. 

• When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we don’t grow without you.
• This is a place where our nurses influence the C-suite.
• Where software engineers change lives.
• Where every associate can build a professional path where they learn and thrive. 
• Through our commitments to wellbeing and work-life balance, we support each associate’s personal health, purpose, work style, sense of belonging, and security. 
• Because finding new ways to put health first—for our members and patients and  our associates alike—is what we do. 

·          

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
<