UM Administration Coordinator

** Become a part of our caring community*
* 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.

As a UM Coordinator you will report to the Manager, UM Administration. You will be part of our fast-paced Clinical Call Center where you will engage with Providers on a daily basis, answering about 30-50 calls per day, and assist with determining the services they will be providing to a member requiring authorization or referral. The Provider may be calling in to get status of an authorization;

or provide clinical information for a pended authorization.

As a UM coordinator you will be collecting clinical information and reviewing resources and data to determine positive outcomes for our consumers. This position requires the use of multiple systems, therefore the ability to maneuver multiple systems at one time is vital.  In this role you will:

+ Take inbound calls to engage members and/or providers to verify clinical information

+ Handle customer inquiries both telephonically and by fax

+ Document all call information according to standard operating procedures and attach clinical information when necessary

+ Identify and escalate issues

** Use your skills to make an impact*
* ** Required Qualifications*
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Experience with Utilization Review and/or Prior Authorization within a managed care call center

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Experience with CGX, Genesys, DIG Toolbar, and SRO

+ UM Clinical intake process experience in Medicare, Medicaid, and DSNP

+ Demonstrated ability to articulate ideas effectively in both written and oral forms

+ Ability to multitask within several computer systems, including Word and Excel, while on the phone

+ Aptitude for quickly learning and navigating new technology systems and applications

+ Must be able to type while taking calls

+ Must have a private office to protect confidential information

** Preferred Qualifications*
* + Bachelor's Degree in Business, Finance or a related field

+ 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

** Additional Information*
* +  
** Workstyle:
** This is a remote position.

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** Core Workdays &

Hours:

** Must be able to work any shift Monday - Friday; 7am - 7pm Central Standard Time (CST).

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*
* 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, paid parental and caregiver…