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Location
Miami, FL, United States
Posted on
Jan 12, 2021
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 or equivalent.
1 years administrative or Call Center experience.
1 more years of experience with prior authorizations within a managed care organization and/or working in a healthcare setting (i.e. hospital, doctors office)
Excellent verbal and written communication skills in English/Spanish
Fully Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. If selected for the position, you will be required to take a Language Proficiency Assessment in English/Spanish. See Additional Information on testing
Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment.
Ability to quickly learn new systems.
Work At Home requirements (temporary due to Covid-19) : 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 of 10x1 (10mbs download x 1mbs upload) is required. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
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.
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
Additional information
Schedule: Monday to Saturday from 8 am to 5 pm, Overtime as per business need. Working on Saturdays is mandatory with a day off during the week (5 working days per week that includes Saturdays)
Training: 4-6 weeks Virtual
Work Location (Address): This permanent job is working from Home temporary due to Covid 19 emergency. This position will deploy to the following location at a future date: 11430 N W 20th Street. Suite 300. Miami, FL 33172
Language Proficiency Testing : Any Humana associate who speaks with a member 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
Sign Up Now - MiamiCrossing.com
Employer job
90 Day Old Job