Experiences at Humana

Know your stuff, articulate your value, look and act professional, and keep an even keel.

Basically operated four different computer programs under the direction of a supervisor. Time on /off phone was monitored and breaks were taken on a mandatory schedule.Was never able to use independent nursing judgement and personal relationships with co-workers were not fostered by supervisors. In a nut shell, I was a human robot who answered the phones with a pre written script and had to obtain permission prior to authorizing any services to providers....

I processed commercial health insurance claims for payment consideration. I also helped train new associates on our team.

* Member Behavior Modeling -- part of Humana Innovation Center
* Smart Statement
* Trend Mitigation Committee and Team
* BI/Informatics Team Development and Architecture Development
* Medical Economics and DM Consultant
* Product Development and MOCHA Research
* Medicare Product Development and Research
* Joint Projects with Pharmaceutical Companies (Pzhier, AstraZenca, and others)
* Joint Projects with Technology Companies (Virgin, Samsung, and others)...

I held various positions including Hospital Materials Manager, Corporate Materials Manager, Corporate Distribution Manager, Manager of Purchasing Systems. I developed corporate inventory standards, materials operations reports, audited materials operations across the country, was in charge of purchasing and materials automation efforts....

I look at overall processes, and look for ways to efficiently improve what we do as a company. Utilizing the Six Sigma methodology to help pinpoint areas that can be course-corrected, my team has been able to avoid the common mistakes that people make of jumping to conclusions without having all of the data. This will enable us to save millions of dollars over the next year....

I work in the Medicare department. I recieve applications that have discrepencies. I try to resolve them so that our members can recieve health coverage in a timely mannor or when they requested it. I also plann pot lucks, birthday lunches and team outtings.

Provided 12 hour support for night shift computer room. Duties included tape backups and tape library while attending school full time.

I have opened mail that has come in and prepped it for filming or scanning. Prepped any certifieds that either needed to be filmed or scanned. I have ran various reports on Microsoft Excel that stated the department's inventory for the day. I delivered folders to other areas for work contained with in to be verified. I have faxed anything that needed to be faxed. I have also keyed in maintenance logs that needed to be keyed in from the previous day. I have also used Lotus Notes....

I started as customer service where I oriented the customer about the benefits of the health plan (the customers also included companys that have the medical plan). Also attended medical and hospital providers and also served as a liason between the companies and the health plan. As a claim analist I started processing and paying medical claims (this included medical specialist and procedures) and then they assigned me to pay hospital claims (that were the less but the more dificults because of the contracts. Also because of a privacy policy of the company I used to pay employees claims. When the company created the operations audit department only two employees (including my self)
started the department where we audits the job of all the claims analist of the department and coordinates trainings for them in case they needed to do a better job....