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UM Administration Coordinator (Claims, UR, PA)

Key Facts

Remote From: 
Full time
Expert & Leadership (>10 years)
English

Other Skills

  • Record Keeping
  • Customer Service
  • Microsoft Office
  • Decision Making
  • Time Management
  • Detail Oriented
  • Learning Agility
  • Verbal Communication Skills

Roles & Responsibilities

  • 2+ years administrative or similar job experience
  • 2+ years of claims experience
  • 2+ years' experience with Utilization Review and/or Prior Authorization within a managed care organization
  • Excellent verbal and written communication skills

Requirements:

  • Contributes to administration of utilization management and performs varied administrative/operational/customer support assignments.
  • Performs computations and handles semi-routine assignments with limited direction.
  • Provides non-clinical support for policies and procedures to ensure appropriate treatment, care or services for members.
  • Interprets policies and methods within defined parameters, with some latitude over prioritization and timing.

Job description

Become a part of our caring community
 

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.

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.


Use your skills to make an impact
 

Required Qualifications

  • 2+ years administrative or similar job experience
  • 2 + years of claims experience
  • 2+ years' experience with Utilization Review and/or Prior Authorization, within a managed care organization.
  • 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.

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.

Additional Information

  • Schedule/Time Zone: Monday through Friday, 8:00 AM – 5:00 PM ET or CT zone with flexibility to work overtime as needed.
  • Work Location: US Nationwide (Stateside)
  • Work Style: Remote

Work-at-Home (WAH) Internet Statement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Employees 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 employees 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 interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay 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.


 

$40,000 - $52,300 per year


 

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.

Application Deadline: 04-04-2026


About us
 

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.


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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.

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