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Billing & Reconciliation
Billing & Reconciliation-April 2024
Miramar
Apr 15, 2025
ABOUT HUMANA
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized whole-person healthcare experiences.
10,000+ employees
Healthcare
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About Billing & Reconciliation

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

  The Billing & Reconciliation Representative 2 determines discrepancies between company records and the records of Center for Medicare and Medicaid Services. The Billing & Reconciliation Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

  The Billing & Reconciliation Representative 2 reconciles accounts each month, documenting any problems found during reconciliation, and provides appropriate plans that will lead to their resolution. Provides exceptional customer service, ensuring that all interested parties are continually updated about the status of their account. Corrects enrollment and cash posting discrepancies as they relate to billing. Prepares documents in order to inform management, market groups, and regional personnel of the status of account issues. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

  Use your skills to make an impact

  Required Qualifications

  Over than 3 years in the healthcare industry

  Knowledge of medical terminology

  Working knowledge of computerized medical management systems and/or web-based programs.

  Working knowledge of claims adjudication principles and procedures, medical and prescription terminology and ICD-9 and CPT-4 codes.

  Detail-oriented with the ability to work on multiple, competing, priorities and is extremely organized.

  Ability to analyze processes and suggest innovative ideas to improve efficiencies.

  Preferred Qualifications

  Bilingual

  Medical Billing Certification

  Scheduled Weekly Hours

  40

  About us

  About onehome: onehome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. onehome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. onehome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

  Equal Opportunity Employer

  It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

  Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

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