Billing and Reconciliation Representative

Billing & Reconciliation Representative 3

Become a part of our caring community and help us put health first. The Billing & Reconciliation Representative 3 is responsible for the reconciliation of revenue received from the Wisconsin Department of Health Services for members enrolled in iCare and Inclusa long term care Medicaid programs. The Billing & Reconciliation Representative 3 performs advanced administrative / operational / customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. The Billing & Reconciliation Representative 3 reconciles monthly capitation payments received for each member, documents any problems found during reconciliation, provides appropriate plans and conducts follow up that will lead to their resolution. Provides exceptional customer service, ensuring that all interested parties are updated about the status. Identifies enrollment and member billing discrepancies as they relate to capitation revenue received. Conducts follow up internally and with external organizations such as county Income Maintenance Consortiums and local Aging and Disability Resource Centers. Prepares and submits contractually required discrepancy and overpayment reports to the Department of Health Services. Decisions typically focus on methods, tactics and processes for completing administrative tasks / projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience / breadth and depth of knowledge of administrative processes and organizational knowledge.

Use your skills to make an impact.

Required Qualifications

• 1+years of experience in accounts receivable.
• Intermediate skills with Excel documents (sorting, filtering, copying and pasting).
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Preferred Qualifications

Must be able to work during core business hours of 8 : 00am-4 : 30pm CST, Monday-Friday.

Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability.

WAH Internet Statement To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria : At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home / Office employees with telephone equipment appropriate to meet the business requirements for their position / job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $43,000 - $56,200 per year.

Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

About Us About Inclusa : Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum. 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.