UM Administration Coordinator 2 - Northeast 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 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.

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

Required Qualifications

High School Diploma

Minimum 1 year administrative or customer service experience

Excellent verbal and written communication skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems

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

Preferred Qualifications

Proficient utilizing electronic medical record and documentation programs

Proficient and/or experience with medical terminology and/or ICD-10 codes

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

Hours for this role are: Monday-Friday 10:00am - 7:00pm EST and a weekend rotation is required

Scheduled Weekly Hours

40

Company info

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