UM Administration Coordinator 2

Profile

Description

The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

Location: Work at Home in the following locationsSan Antonio, TX; Green Bay, WI; Metairie, LA; Louisville, KY in office - 24x7 call center must be able to work a variety of shifts that could include weekends.

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.

As a UM Coordinator you will be part of our fast paced Clinical Call Center where you will engage with providers on a daily basis, answering about 30-50 calls per day where you will assist providers with determining the service they will be providing to a member requires authorization or referral; the provider may be calling in to get status of an authorization; the provider may be calling in to provide clinical information for a pended authorization. As a UM coordinator you will be collecting clinical information and reviewing resources and data to determine positive outcomes for our consumers. This position requires the use of multiple systems, therefore the ability to maneuver multiple systems at one time is vital. In this role you will:


Take inbound calls to engage members and/or providers to verify clinical information
Handle customer inquiries both telephonically and by fax
Document all call information according to standard operating procedures and attach clinical information when necessary
Identify and escalate issues


Required Qualifications


High School Diploma
Experience with CGX systems
Excellent verbal and written communication skills
Ability to multitask within several computer systems while on the phone
Aptitude for quickly learning and navigating new technology systems and applications
Must be able to type while taking calls
Proficiency in Microsoft Office applications, including Word and Excel
Must have a private office to protect confidential information
Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
Must be available to work a variety of shifts including possible weekends.


Preferred Qualifications


Proficient utilizing electronic medical record and documentation programs
Proficient and/or experience with medical terminology and/or ICD-10 codes
Bachelor's Degree in Business, Finance or a related field
Prior member service or customer service telephone experience desired
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization


Additional Information

Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Scheduled Weekly Hours

40

Company info

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