UM Administration Coordinator Mid-West 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 for the Peer to Peer Team will be responsible for answering inbound/outbound departmental phones. This team also provides non-clinical support to our Medical Directors as it relates to the policies and procedures ensuring best and most appropriate treatment, care or services for our 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 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
Creation and distribution of determination letters
Collaborate with multiple roles/departments/providers/team members


Required Qualifications


1 or more years' experience working in an administrative or customer service support capacity
Excellent verbal and written communication skills
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Comprehensive knowledge of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems


Preferred Qualifications


Proficient utilizing electronic medical record and documentation programs
Proficient and/or experience with medical terminology and/or ICD-10 codes
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Call center phone experience is a plus


Work-At-Home Requirements


At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Additional Information


Hours for this role are: Monday-Friday, 10am-7pm EST or 9am-6pm CST


#LI-Remote

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

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