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

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.

Required Qualifications

High School Diploma

Bilingual (English & Spanish)

2 or more years within the Medical Field or Customer Service experience

Excellent verbal and written communication skills

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

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

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

A dedicated home office space, with a locked door, lacking ongoing interruptions to protect member PHI / HIPAA information

Work shift will be in Eastern Time Zone

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 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

Language Proficiency Testing : Any Humana associate who speaks in a language other than Spanish and/or English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Scheduled Weekly Hours

40

Company info

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