Description
Become a part of our caring community and help us put health first
The Prior Authorization UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.Prior Authorization UM Administration Coordinator 2
- Support the UM Nurses to process discharge orders and arrange a safe facility discharge.
- Work with UM Nurses, Pharmacy, Medical Directors and other Departments.
- Make calls to UM Nurses, Hospitals, Skilled Nursing Facilities and other vendors.
- Document all calls and requests.
- Search for Medicare and Medicaid Guidelines.
- Process all incoming fax/emails request for services the same day.
- Return call for all voice messages received the same day.
- Process provider and member letters (Letter of Agreements, Approvals, Denials etc.)
- Mail letters to members.
- Assist the team with various clerical/administrative tasks as necessary.
- Participate in special projects as assigned by your Supervisor or Manager.
Use your skills to make an impact
Required Qualifications
- 1 or more years of experience with Utilization Review and/or Prior Authorization
- 1 or more years of Healthcare experience
- Working knowledge of Microsoft Word, Excel, and Outlook.
- Live in CST or EST states
- Monday-Friday 8am-5pm EST, and work 1 weekend a quarter. Schedule subject to change based on business needs.
Preferred Qualifications
- Bilingual English/Spanish
- Proficient utilizing documentation programs.
- Experience with the CarePlus Platform.
- Proficient and/or experience with medical terminology and/or ICD-10 codes.
- Member services
Additional Information
Work Schedule:
Monday-Friday 8am-5pm EST, and work 1 weekend a quarter. Schedule subject to change based on business needs.
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Work at Home Guidance
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
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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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
