Claims Processing Representative

Humana is committed to putting health first and is seeking a Claims Processing Representative to join their team. The role involves reviewing and adjudicating complex claims, performing administrative tasks, and making decisions based on organizational policies and procedures. Responsibilities Reviews and adjudicates complex or specialty claims, submitted either via paper or electronically Performs varied activities and moderately complex administrative/operational/customer support assignments Performs computations Determines whether to return, deny, or pay claims following organizational policies and procedures Works within defined parameters to identify work expectations and quality standards Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion Skills MUST reside within 50 miles of the following Humana location: 101 E. Main St, Louisville, KY 40202 Analytical thinking skills and comfortable working independently and with minimal supervision Prior experience working with multiple computer systems at a time and multitasking through those effectively Ability to manage multiple or competing priorities, including use of multiple computer applications simultaneously Excellent verbal and written communication skills Proficiency in all Microsoft Office: Word, PowerPoint, Excel 1+ years of experience within the healthcare and/or insurance industries Must be passionate about contributing to an organization focused on continuously improving consumer experiences CAS Claims processing experience Bachelor's Degree Benefits Medical, dental and vision benefits 401(k) retirement savings plan Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) Short-term and long-term disability Life insurance Company Overview Humana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is Company H1B Sponsorship Humana has a track record of offering H1B sponsorships, with 282 in 2025, 246 in 2024, 284 in 2023, 274 in 2022, 212 in 2021, 84 in 2020. Please note that this does not guarantee sponsorship for this specific role.