[Remote] UM Administration Coordinator
Note: The job is a remote job and is open to candidates in USA. Humana Inc. is a leading U.S. healthcare company seeking a UM Administration Coordinator to contribute to the administration of utilization management. The role involves processing authorization requests, maintaining records, and collaborating with care teams to ensure appropriate treatment for members.
Responsibilities
- Accurately and efficiently process and enter authorization requests into the system
- Review care team submitted service requests and validate required documentation before processing
- Coordinate follow-up with the care team for missing or additional required information
- Maintain detailed records of authorization approvals, denials, and modifications
- Collaborate with UM nurses and care teams to escalate requests requiring additional clinical review
- Monitor authorization timelines and turnaround times to prevent delays
- Serve as a liaison between providers, members, and internal teams, ensuring smooth communication regarding service approvals
- Identify potential discrepancies, errors, or inefficiencies and work proactively to resolve them
- Assist with training and onboarding of new team members as needed
Skills
- 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
- 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
Benefits
- 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
Company Overview
Company H1B Sponsorship