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 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.

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

• Experience working in the healthcare Industry is highly preferred
• 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

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 8am-5pm or 9am-6pm CST

Scheduled Weekly Hours

40