UM Administration Coordinator
Remote US
The UM Administration Coordinator 2 provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and with other team members.
Achieve your best at Humana. Join Us! The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.
Key Responsibilities:
Attaching faxes for chart reviews for the nursing team
Answering departmental phones as assigned
Make outbound calls to engage providers to verify clinical information/discharge date and admission status
Document calls and attach clinical information received
Request clinical information from providers/facilities
Create and send out written correspondence
Ability to multitask and prioritize
Creation and distribution of determination letters
Collaborate with multiple roles/departments/providers/team members
Use your skills to make an impact
Required Qualifications
1 or more years’ experience working in an administrative support capacity in the healthcare industry
Prior professional experience of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems (proficient to advanced)
Prior experience in a metric driven environment
Preferred Qualifications
Proficient utilizing electronic medical record and documentation programs
Proficient and/or experience with medical terminology and/or ICD-10 codes
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Additional Information
Hours for this role are: Monday – Friday, 8-hour shift will fall between the hours of 7:00am-7:00pm EST and a Saturday rotation may be required based on business needs
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. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Work at Home / 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 recommended; 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 …
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Remote US Work from a dedicated space Work from a dedicated space lacking ongoing interruptions
Benefits/PerksCompetitive benefits Dental Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Time off Vision Vision Benefits Volunteer time Volunteer time off
Tasks- Documentation
- Training
BI Business Data Documentation Excel Healthcare HIPAA Leadership Managed Care Medicaid Medical terminology Medicare Microsoft Word Nursing Outlook Prior authorization Security Technology Utilization management Utilization Review Wellness
Experience1 year
Education TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9