UM Administration Coordinator

San Antonio, Texas, United States

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Full TimeJob Type

UnknownVisa

Health InsuranceIndustries

Requirements

Candidates must possess a High School diploma, administrative or technical support experience, and excellent verbal and written communication skills. A working knowledge of MS Office (Word, Excel, Outlook) in a Windows environment is required, along with the ability to quickly learn new systems. Preferred qualifications include proficiency with electronic medical record programs, medical terminology, ICD-10 codes, prior member or customer service telephone experience, and experience with Utilization Review or Prior Authorization in a managed care setting.

Responsibilities

The UM Administration Coordinator 1 provides non-clinical support for utilization management policies and procedures, ensuring members receive the best and most appropriate treatment, care, or services. This role performs basic administrative, clerical, operational, customer support, and computational tasks on routine and patterned assignments under close supervision.

Skills

Administrative Support

Clerical Support

Customer Support

MS Office

Word

Excel

Outlook

Windows

Electronic Medical Records

Medical Terminology

ICD-10 Codes

Member Service

Customer Service

Utilization Review

Prior Authorization

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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