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 the policies and procedures ensuring best and most appropriate treatment, care or services for members.

Telephonic UM Coordinator/ UM Administration Coordinator 2 

• Primarily receive calls from Providers, Hospitals, Skilled Nursing Facilities and other vendors

• Support the UM Nurses to process discharge orders and arrange a safe facility discharge.

• 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/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
 

Additional Job Description

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.

• Monday-Friday 8am-5pm EST must have 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 with Utilization Review and/or Prior Authorization, preferably within a managed care organization.

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