Humana

UM Administration Coordinator

Florida, United States

Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

Candidates should possess at least one or more years of Administrative support experience, at least one or more years of Healthcare experience, and at least one or more years of telephonic Customer Service experience. Working knowledge of Microsoft Word, Excel, and Outlook is required, along with the ability to work Nights, Weekends and Holidays based on business needs. Candidates must reside in Eastern Standard Time (EST) state.

Responsibilities

The UM Administration Coordinator 2 will provide non-clinical support for policies and procedures, ensuring best and most appropriate treatment, care, or services for members. They will work member cases from the member side, approve or send requests for medical review, document all calls and requests, search for Medicare and Medicaid Guidelines, process all incoming fax/emails and letters, assist with clerical/administrative tasks, participate in special projects, and use skills to make an impact.

Skills

Microsoft Word
Excel
Outlook
Medical terminology
ICD-10 codes
Customer Service
Administrative support
Utilization Review
Prior Authorization
Bilingual English/Spanish

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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