UM Administration Coordinator Mid-West Region

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

Achieve your best at Humana. Join Us! The UM Administration Coordinator 2 for the Peer to Peer Team will be responsible for answering inbound/outbound departmental phones. This team also provides non-clinical support to our Medical Directors as it relates to the policies and procedures ensuring best and most appropriate treatment, care or services for our 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.

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

Required Qualifications

1 or more years' experience working in an administrative or customer service support capacity

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

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

Call center phone experience is a plus

Work-At-Home Requirements

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 for this role are: Monday-Friday, 10am-7pm EST or 9am-6pm CST

#LI-Remote

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com