UM Administration Coordinator 2 - WAH in Florida

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

UM Admin Coord Job Description

Where you Come In

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.

Duties include:

Triage internal and external phone calls appropriately.

Communicate with providers to request clinical information and coordinate case dispute reviews.

Review and attach clinical information to authorizations.

Generate, proof, and send letters to members.

Hours 9AM- 6PM

Required Qualifications - What it takes to Succeed

High School Diploma

1 years 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

Advanced 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

Proven experience working with tight deadlines/timeframe in an ever changing environment

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: 9am-6pm EST

How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Scheduled Weekly Hours

40

Company info

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