Note: The job is a remote job and is open to candidates in USA. Humana is a healthcare organization serving members through insurance and healthcare services. The UM Administration Coordinator 2 supports Medicaid utilization management by organizing prior authorization documentation, verifying eligibility and benefits, researching participating status, and ensuring accurate, timely data entry and processing.
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
- Research participating status to ensure compliance with Humana policies
- Verify member eligibility and benefits for prior authorization requests
Skills
- One (1) or more years of administrative experience in a healthcare environment
- Proficient in Microsoft Office applications, including Word, Excel, and Outlook, within a Windows-based environment
- Comfortable learning and using new systems, tools, and technology
- Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required
- Experience with utilization review or prior authorization within a managed care organization
- Proficient using electronic medical record and documentation programs
- Experience with medical terminology and ICD-10 codes
- Prior provider service or customer service telephone experience
Benefits
- This is a remote position.
- 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
Company Overview
Company H1B Sponsorship