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Posted 29 days ago
Requirements and responsibilities
Shift Requirements:
- Candidates need to be available for a later shift: 7:00 PM CST / 8:00 PM EST.
- Candidates need to be available for weekend shifts.
Training:
- The first month will be training from 8:00 AM to 4:30 PM CST.
Potential:
- Conversion.
Role Summary:
- The UM Administration Coordinator 2 supports the administration of utilization management and access to care for members and their representatives.
- This role is responsible for performing advanced administrative, operational, and customer support tasks that require independent initiative and sound judgment.
- The position also demands strong problem-solving skills to address and facilitate Humana members’ access to care needs.
Job Description:
- The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.
- Decisions typically focus on methods, tactics, and processes for completing administrative tasks/projects.
- Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques.
- Works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.
Required Qualifications:
- 2 or more years of customer service, administrative, or technical support experience.
- Excellent verbal and written communication skills.
- Advanced knowledge of MS Office including Word, Excel, and Outlook in a Windows-based environment and an ability to quickly learn new systems.
- Must have accessibility to high-speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 25 upload and 10 download.
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications:
- Experience navigating utilization management processes or coordinating care for members.
- Bachelor's Degree in Business, Finance, or a related field.
- Prior member service or customer service telephone experience desired.
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
- Proficient utilizing electronic medical record and documentation programs.
- Proficient and/or experience with medical terminology and/or ICD-10 codes.
Additional Information:
- As part of our hiring process for this opportunity, we will be using a technology called Montage Voice which allows us to quickly connect and gain valuable information from you about your relevant experience.
- If you are selected for a phone screen, you will receive an email inviting you to participate in a Montage Voice interview.
- During this call, you will be asked a set of questions pertaining to this particular role and you will provide recorded responses.
- The entire process takes about 15-20 minutes and can be done at your convenience.
- Your responses will be reviewed and you will be informed if you were selected for an in-person or video interview, depending on your location.
Key Items:
- Attendance.
- Camera on.
- Dedicated workspace.
Notes:
- Bachelor’s degree is not required/preferred.
- UM knowledge of codes.
- Genesis is the software they use.
- Customer Service Experience in healthcare/insurance.