Job Description
Become a part of our caring community
Join Humana's Medicaid Utilization Management (UM) team and help members access the care they need. As a UM Administration Coordinator 2, you will support the prior authorization process by managing clinical documentation, verifying member eligibility and benefits, and ensuring accurate, timely processing of requests. This position is ideal for a detail-oriented healthcare professional who enjoys working in collaborative environment and contributing to positive member outcomes. You'll leverage your administrative and customer support skills while gaining exposure to utilization management processes within a leading healthcare organization.
- Manage and organize documentation related to prior authorization requests, including clinical requests and receipt of clinicals.
- Maintain accurate records and ensure timely data entry into the clinical documentation system.
- Research participating status to ensure compliance with Humana policies.
- Verify member eligibility and benefits for prior authorization requests.
Use your skills to make an impact
Required Qualifications
- One (1) or more years of administrative experience in a healthcare environment.
- Proficient in Microsoft Office applications, including Word, Excel, and Outlook, within a Windows-based environment.
- Comfortable learning and using new systems, tools, and technology.
Preferred Qualifications
- Experience with utilization review or prior authorization within a managed care organization.
- Proficient using electronic medical record and documentation programs.
- Experience with medical terminology and ICD-10 codes.
- Prior provider service or customer service telephone experience.
Additional Information
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Workstyle: This is a remote position.
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Work Schedule: This position operates on an 8:00 AM to 5:00 PM Eastern Time (ET) schedule. Regular workdays are not limited to Monday through Friday and include weekend coverage based on business needs and scheduling requirements.
Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.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.$40,000 - $52,300 per yearDescription 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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.
Originally posted on Himalayas
