Healthcare Insurance Eligibility Specialist

Welcome to Humana, a leading healthcare company dedicated to improving the health and well-being of our members. We are currently seeking a Healthcare Insurance Eligibility Specialist to join our team. In this role, you will play a crucial part in ensuring our members have access to the healthcare services they need by verifying their eligibility and benefits. To excel in this position, you must have a strong understanding of insurance eligibility and claims processes, excellent communication skills, and a passion for helping others. If you are looking for a rewarding career in the healthcare industry, we would love to have you on our team.

Verify Member Eligibility: The Healthcare Insurance Eligibility Specialist will be responsible for verifying the eligibility of Humana members to ensure they have access to the healthcare services they need.

Understand Insurance Processes: The specialist must have a strong understanding of insurance eligibility and claims processes to accurately verify member eligibility and benefits.

Communicate with Members: The specialist will communicate with members to gather necessary information and explain their eligibility and benefits.

Collaborate with Team Members: The specialist will work closely with other team members to ensure accurate and timely verification of member eligibility.

Maintain Documentation: The specialist will maintain accurate documentation of member eligibility and benefits verification for reference and auditing purposes.

Stay Up-to-Date on Insurance Changes: The specialist will stay updated on any changes in insurance eligibility and benefits to ensure accurate verification for members.

Provide Excellent Customer Service: The specialist will provide excellent customer service to members by addressing any questions or concerns they may have regarding their eligibility and benefits.

Ensure Compliance: The specialist will ensure compliance with all regulatory and company policies and procedures related to verifying member eligibility.

Handle Inquiries: The specialist will handle inquiries from members, healthcare providers, and internal stakeholders regarding member eligibility and benefits.

Contribute to Team Success: The specialist will contribute to the overall success of the team by meeting individual and team goals related to member eligibility and benefits verification.

Humana is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

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