UM Administration Coordinator at Humana in Remote

Summary: Humana is a leading U.S. healthcare company, and they are seeking a UM Administration Coordinator to provide essential administrative support for the National Medicaid Clinical Operations team. The role involves managing documentation, coordinating communication, and ensuring smooth prior authorization processes.

Responsibilities:
- Manage and organize documentation related to prior authorization requests, including clinical requests and receipt of clinicals
- Maintain accurate records and ensure timely data entry into the clinical documentation system
- May work from reports to conduct data entry into the clinical documentation system for the team
- Research participating status to ensure compliance with Humana policies
- Verify member eligibility and benefits for prior authorization requests
- Serve as a point of contact for internal and external stakeholders regarding prior authorization inquiries
- Coordinate communication between healthcare providers and the prior authorization team
- Collaborate with team members to ensure seamless integration of prior authorization processes

Required Qualifications:
- 1+ year in administrative experience in a healthcare setting
- Working knowledge of MS Office including Word, Excel, and Outlook

Preferred Qualifications:
- Proficient utilizing electronic medical record and documentation programs
- Proficient and/or experience with medical terminology and/or ICD-10 codes
- Bachelor's Degree
- Prior member service or customer service telephone experience desired
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Required Skills: Administrative experience in healthcare, MS Office Word, MS Office Excel, MS Office Outlook, Electronic medical record systems, Medical terminology, ICD-10 codes, Utilization Review, Prior Authorization, Member eligibility verification

Benefits: Medical, dental and vision benefits, 401(k) retirement savings plan, Time off (including paid time off, company and personal holidays, paid parental and caregiver leave), Short-term and long-term disability, Life insurance, Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information., At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.