Telephonic - UM Administration Coordinator / UM Administration Coordinator 2

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. The Telephonic - UM Administration Coordinator / UM Administration Coordinator 2 provides non-clinical support for policies and procedures, ensuring the best and most appropriate treatment, care, or services for members.

Responsibilities

• Primarily receive calls from Providers, Hospitals, Skilled Nursing Facilities, and other vendors.
• Support UM Nurses to process discharge orders and arrange safe facility discharges.
• Work with UM Nurses, Pharmacy, Medical Directors, and other Departments.
• During downtime, 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/email requests for services the same day.
• Return calls 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 Administrative support experience.
• 1 or more years of Healthcare experience.
• 1 or more years of telephonic Customer Service experience.
• Working knowledge of Microsoft Word, Excel, and Outlook.
• Ability to work Nights, Weekends, and Holidays based on business needs.
• Bilingual English/Spanish: Able to speak, read, and write in both languages without limitations or assistance. (See Additional Information on testing).

Preferred Qualifications

• Proficient utilizing documentation programs.
• Experience with the CarePlus Platform.
• Proficient and/or experience with medical terminology and/or ICD-10 codes.
• Member service experience.
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.

Work Schedule

• Monday-Friday 8am-5pm EST.
• Must work 1 weekend a quarter.
• Schedule subject to change based on business needs.

Application Instructions

As part of our hiring process, we will be using interviewing technology provided by HireVue. If selected to move forward, you will receive an invitation for a pre-recorded Voice Interview and/or an SMS Text Messaging interview.

• Voice Interview: Respond to interview questions via your phone (approx. 10-15 minutes).
• SMS Text Interview: Answer questions using your cell phone or computer (approx. 5-10 minutes).

Your recorded interview(s) will be reviewed, and you will be informed if you are moving to the next round of interviews.

Work at Home Guidance

To ensure effective work for Home or Hybrid Home/Office associates, your self-provided internet service must meet the following criteria:

• Recommended: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps. Wireless, wired cable, or DSL connection is suggested.
• Acceptable (with approval): Satellite, cellular, and microwave connections can be used only if approved by leadership.
• Internet Expense Reimbursement: Associates living and working from Home in 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 appropriate telephone equipment to meet business requirements. Associates must work from a dedicated space lacking ongoing interruption.