[Remote] Consumer Service Operations Representative III

Note: The job is a remote job and is open to candidates in USA. Humana is a health insurance company committed to putting health first. The Consumer Service Operations Representative III is responsible for daily activities across multiple service functions, including client support, claims processing, and customer service, while exercising discretion and judgment in administrative tasks. Responsibilities Perform advanced administrative/operational/customer support duties that require independent initiative and judgment May apply intermediate mathematical skills Perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations Investigate and settle claims and customer service issues Make decisions focusing on methods, tactics and processes for completing administrative tasks/projects Regularly exercise discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques Work under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge Skills Must be able/willing to travel between the 4 different locations in Stuart, East St. Lucie, Southeast St. Lucie, and West St. Lucie (zip codes ranging from 34994, 34952, 34984, and 34986). You will travel to a different clinic each day Minimum 1 year of customer service experience in a healthcare setting Proficient in Microsoft Office, Outlook, Word, and Excel Excellent verbal, listening and written communication skills Aptitude for quickly learning and navigating new technology, systems and applications as well as working knowledge of computers Undergraduate Degree Clerical support experience in a healthcare environment CNA or Medical Assistant experience Quality experience Medicare experience Familiarity with medical terminology and/or ICD-10 codes Benefits Medical, dental and vision benefits 401(k) retirement savings plan 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.