Bilingual Consumer Service Operations Rep
H
Humana
📍 Miramar, FL, United States
Job Description
**Become a part of our caring community**
Join Humana's Infusion Pharmacy team and help patients access the medications and care they need. As a Bilingual Consumer Service Operations Representative, you will partner with providers, patients, and health plans to manage pharmacy referrals and prior authorizations for managed care members. Reporting to the Consumer Service Operations Supervisor, you will review and process health and prescription claims, ensure compliance with payer requirements, including Medicare and Medicaid guidelines, and help guide efficient, accurate service delivery.
You'll serve as a trusted resource for customers and healthcare providers, resolve complex issues, support audits and special projects, and contribute to team success by mentoring and training colleagues. This is an excellent opportunity for someone who enjoys problem-solving, collaborating across teams, and making a meaningful impact on patient care.
**Responsibilities:**
Join Humana's Infusion Pharmacy team and help patients access the medications and care they need. As a Bilingual Consumer Service Operations Representative, you will partner with providers, patients, and health plans to manage pharmacy referrals and prior authorizations for managed care members. Reporting to the Consumer Service Operations Supervisor, you will review and process health and prescription claims, ensure compliance with payer requirements, including Medicare and Medicaid guidelines, and help guide efficient, accurate service delivery.
You'll serve as a trusted resource for customers and healthcare providers, resolve complex issues, support audits and special projects, and contribute to team success by mentoring and training colleagues. This is an excellent opportunity for someone who enjoys problem-solving, collaborating across teams, and making a meaningful impact on patient care.
**Responsibilities:**