The UM Administration Coordinator 2 provides non-clinical support, following established policies and procedures ensuring best and most appropriate treatment, care, or services for members.
Prepares and forwards authorization request to clinical review
Works within defined parameters to identify work expectations and quality standards, but has some autonomy over prioritization/timing, and works under minimal direction.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Key Responsibilities:
Completes inbound and outbound provider calls to answer UM related questions and prepare authorization request for clinical review
Document calls and attach clinical information to the member’s medical record
Create and send out written correspondence
Ability to multitask and prioritize
Collaborate with multiple roles/departments/providers/team members
Required Qualifications
Minimum 1 year healthcare or clinical experience (working for a health plan, organization, or provider)
Excellent verbal and written communication skills
Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems and ability to troubleshoot and resolve basic technical difficulties in a remote environment.
Preferred Qualifications
Proficient utilizing electronic medical record and documentation programs
Prior member service or customer service telephone experience desired
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Clerical support background in a healthcare environment
Familiarity with medical terminology and/or ICD-10 codes
CNA or Medical Assistant background a plus
Additional Information
Workstyle: Remote work at home
Location: Oklahoma
Training Schedule: Must be able to attend training schedule. Monday through Friday; 8:00 AM - 5:00 PM Central Time
Work Schedule: Monday through Friday 8:00 AM - 4:30 PM Central with rotating Saturday mornings, (about every 6th weekend)
Travel: Minimal travel for office meetings 1-2 times annually
Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
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
Interview Format
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Modern Hire Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first-round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Modern Hire Voice interview. In this interview, you will listen to a set of interview questions over your phone, and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
SSN Alert
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Benefits
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
Health benefits effective day 1; Paid time off, holidays, volunteer time and jury duty pay; Recognition pay; 401(k) retirement savings plan with employer match; Tuition assistance; Scholarships for eligible dependents; Parental and caregiver leave; Employee charity matching program; Network Resource Groups (NRGs); Career development opportunities
#L1-Remote
Scheduled Weekly Hours
40Pay 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.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Empire Life
Floor and Decor
Genmab
Parexel
Syska Hennessy Group
