Jobs / United States / Humana INC
Grievances & Appeals Expedited Case Rep
Humana INC · 🇺🇸 Remote Nationwide · Remote
Sponsorship verdict
Sponsorship possible
One solid signal, not two — worth applying, and worth asking about sponsorship early.
- Employer is on a government sponsor recordThe US Department of Labor certified 260 H-1B/E-3 labor condition applications for this employer between Oct 2025 and Jun 2026 (latest Jun 2026) — the step every H-1B hire needs first. USCIS also records 130 H-1B approvals in FY2023. Source: LCA disclosure data (US Department of Labor (OFLC)).
- The posting doesn’t mention sponsorshipSilence isn’t a refusal — ask the recruiter before investing much time.
- No salary bar for this routeH-1B has no fixed salary bar: the employer must pay at least the prevailing wage for the role and area. Cap-subject employers enter a lottery weighted by wage level. Source: https://www.federalregister.gov/documents/2025/12/29/2025-23853/weighted-selection-process-for-registrants-and-petitioners-seeking-to-file-cap-subject-h-1b, rules effective 2026-02-27.
- Last confirmed live 3 days agoWhen a source last listed this job as open.
US H-1B: cap-subject employers enter a lottery weighted by wage level — Level I gets 1 entry, Level IV gets 4 (DHS projected selection odds ≈15% at Level I to ≈61% at Level IV). Universities and non-profit research employers are cap-exempt. The $100,000 fee for new petitions from abroad is currently blocked by a court order (appeal pending).
A verdict summarises public evidence; it is not legal advice and never a guarantee — the employer and the immigration authority decide. Sign in to factor in where you can already work.
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Sponsor Radar — Humana INC
The US Department of Labor certified 260 H-1B/E-3 labor condition applications for this employer between Oct 2025 and Jun 2026 (latest Jun 2026) — the step every H-1B hire needs first. USCIS also records 130 H-1B approvals in FY2023. Source: LCA disclosure data (US Department of Labor (OFLC)).
Past sponsorship or register membership never guarantees sponsorship for this vacancy or for you. Full Sponsor Radar for Humana INC →
About the role
Become a part of our caring community The Grievances & Appeals Representative 3 works expedited Medicaid and AIP (dual) appeals cases and reviews clinical documentation to determine if an appeal is warranted. This is an extremely high-volume, fast-paced role, with the responsibility of moving several cases per hour. You will need to have proactive queue management, experience handling support requests across multiple workstreams, ability to adjust to changing processes, and effective communication with managers and team leads. You will report to the Grievances & Appeals Supervisor. As a Grievances & Appeals Representative 3, you will: • Review and evaluate several expedited Medicaid and AIP (dual) cases per hour. Caseload volume varies as it is a consistently significant high-volume role. • Manage cases from assignment to resolution, conducting analytic reviews of clinical documentation and collaborating with business partners to complete investigations. • Assess case urgency and process cases in chronological order, ensuring resolution within strict turnaround times (typically 24 hours). • Make outbound calls on every case to deliver outcome to members or providers, or request documentation, clarify case details or address outstanding issues. • Stay current with frequently changing mentor documents and workflows. • Monitor multiple workstreams and adapt quickly to process changes. • Communicate gaps or issues and seek guidance as needed. Use your skills to make an impact Required Qualifications • 1+ years of customer service experience • 1+ years of experience in the healthcare industry or medical field • Must have experience with production and meeting performance metrics • Intermediate experience with Microsoft Office programs (including Word, Excel, Outlook, and Teams) and comfortability working across multiple software systems • Experience managing a high-volume, rapidly changing workload while remaining self-sufficient, managing shifting priorities, and adapting to new processes without disruption Preferred Qualifications • Previous inbound call center or related customer service experience • Prior Grievances and Appeals experience • Previous experience processing medical authorizations • Bilingual (English and Spanish); with the ability to read, write, and speak English and Spanish • Prior experience with Medicare or Medicaid • Knowledge of medical terminology Required Training Schedule: • Virtual training will start day one and will last for approximately four (4) weeks. Training will be held Monday through Friday and will follow a schedule between 8:00 am – 5:00 pm Eastern Time. Training hours will be communicated prior to the start date. • Attendance is vital for success; no time off is allowed during training and is limited within the first 180 days. Required Work Schedule: • Following training, must be able to work 11:30 am – 8:00 pm Eastern, Tuesday through Saturday, with alternating holidays and overtime as needed. • Hours are subject to change based on business needs. • Must commit to working within the department for a minimum of eighteen (18) months. Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PH