[Hiring] Utilization Management Administration Coordinator @Humana

Role Description

The UM Administration Coordinator 2 supports the administration of utilization management by performing a variety of moderately complex administrative, operational, and customer service tasks.

• Significant telephonic interaction with providers, members, and other stakeholders.
• Receiving inbound calls and providing customer service.
• Supporting the intake of utilization management and prior authorization requests.
• Creating and processing authorization cases.
• Generating correspondence and triaging faxes and shared mailboxes.
• Processing documentation, conducting calculations, and data processing.
• Providing non-clinical support for policies and procedures.
• Responding to questions and supporting the intake and processing of utilization management requests.
• Building and updating authorization cases and creating letters and other correspondence.
• Reviewing and routing documentation and completing other non-clinical administrative activities.
• Demonstrating flexibility as work assignments may change based on business needs and operational priorities.

Qualifications

• 1 or more years of administrative, technical support, customer service, or related experience.
• Excellent verbal and written communication skills.
• Ability and willingness to provide customer service and intake support through high-volume inbound telephone interactions.
• Ability to simultaneously communicate by telephone, navigate multiple systems/screens, accurately document interactions, and process information.
• Working knowledge of MS Office, including Word, Excel, and Outlook in a Windows-based environment.
• Must have accessibility to high-speed DSL or cable modem for a home office.
• Ability to adapt to changing work assignments based on business and operational needs.
• Ability to work between the hours of 8 a.m. and 8 p.m. EST, including rotational weekend work.

Requirements

• Proficient utilizing electronic medical record and documentation programs.
• Proficient and/or experienced with medical terminology and/or ICD-10 codes.
• Bachelor's degree in Business, Finance, or a related field.
• Prior member, provider, call center, or customer service telephone experience.
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.

Work-At-Home Requirements

• Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role).
• A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required.
• A dedicated office space lacking ongoing interruptions to protect member PHI / HIPAA information.

Scheduled Weekly Hours

40

Pay Range

The 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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$40,000 - $52,300 per year

Description of Benefits

• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance and many other opportunities.