DescriptionThe 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
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. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
**This is a weekend role and the hours are: Thursday-Sunday 7am-6pm CST or Friday-Monday 7am-6pm CST. Holidays hours may be required, as well as OT based on a business need**
Key Responsibilities:
- Attaching faxes for chart reviews for the nursing team
- Answering departmental phones as assigned
- Make outbound calls to engage members and/or 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
- Collaborate with multiple roles/departments/providers/team members
- Working with QIO Appeals
Required Qualifications
- 1 or more years of administrative, telephonic customer service and/or healthcare experience
- Excellent verbal and written communication skills
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Comprehensive knowledge 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
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
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
Work-At-Home Requirements
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Additional Information
- Hours are: Thursday-Sunday 7am-6pm CST or Friday-Monday 7am-6pm CST. Holidays hours may be required, as well as OT based on a business need
- This is a remote position
#LI-Remote
Scheduled Weekly Hours40
Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$34,500 – $47,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.