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Humana UM Administrative Coordinator 2 (Part TIme)- Florida Region (Saturday and Sunday 8:30-5pm EST) in Louisville, Kentucky

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

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.

Key Responsibilities:

  • Attaching faxes for chart reviews for the nursing team

  • Answering departmental phones as assigned

  • Make outbound calls to engage members and/or providers to verify clinical information/discharge date and admission status

  • Document calls and attach clinical information received

  • Request clinical information from providers/facilities

  • Create and send out written correspondence

  • Ability to multitask and prioritize

  • Collaborate with multiple roles/departments/providers/team members

Required Qualifications

  • High School Diploma

  • 1 or more years administrative or technical support experience

  • 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

  • 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

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Proficient utilizing electronic medical record and documentation programs

  • Proficient and/or experience with medical terminology and/or ICD-10 codes

  • Bachelor's Degree in Business, Finance or a related field

  • 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 for this role are: Saturday-Sunday 8:30am-5pm EST

Scheduled Weekly Hours

16

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