Company name
Humana Inc.
Location
Tampa, FL, United States
Employment Type
Full-Time
Industry
Administrative, Customer Service
Posted on
Mar 13, 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
UM Admin Coord Job Description
Where you Come In
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.
Duties include:
Triage internal and external phone calls appropriately.
Communicate with providers to request clinical information and coordinate case dispute reviews.
Review and attach clinical information to authorizations.
Generate, proof, and send letters to members.
Hours 9AM- 6PM
Required Qualifications - What it takes to Succeed
High School Diploma
1 years administrative or customer service experience
Excellent verbal and written communication skills
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Advanced knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
Proven experience working with tight deadlines/timeframe in an ever changing environment
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 desired
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Additional Information
Hours: 9am-6pm EST
How we Value You
Benefits starting day 1 of employment
Competitive 401k match
Generous Paid Time Off accrual
Tuition Reimbursement
Parent Leave
Go365 perks for well-being
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com