[Hiring] Medicaid Claims Administration Coordinator @Humana

Role Description

The UM Administration Coordinator 2 contributes to administration of utilization management for Humana's KY Medicaid plan. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments, including:

• Performing computations.
• Providing non-clinical support for procedures ensuring best treatment, care, or services for members.
• Making decisions focused on interpretation of area/department policy and methods for completing assignments.
• Working within defined parameters to identify work expectations and quality standards.
• Following standard policies with some opportunity for interpretation/deviation and independence.

Qualifications

• 2+ years of experience in medical claims.
• 1+ years of Medicaid experience.
• 2+ years of experience with Utilization Review (UR) and/or Prior Authorization (PA) processes within a managed care organization.
• 2+ years of administrative experience or experience in a similar healthcare, insurance, or managed care role.
• Working knowledge of MS Office including Word, Excel, and Outlook in a Windows-based environment.
• An ability to quickly learn new systems.

Requirements

• Proficient using electronic medical record and documentation programs.
• Proficient or experience with medical terminology or ICD-10 codes.
• Prior member service or customer service telephone experience.

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.
• Many other opportunities supporting whole-person well-being.

Additional Information

• Schedule/Time Zone: Monday through Friday, 8:00 AM – 5:00 PM ET or CT zone with flexibility to work overtime.
• Work Location: US Nationwide (Stateside).
• Work Style: Remote.
• Work at Home Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps required; a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.
• Scheduled Weekly Hours: 40.
• Pay Range: $40,000 - $52,300 per year.