UM Specialist

Profile

Description

The UM Specialist /UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Responsibilities

Achieve your best at Humana. Join Us! The UM Specialist / 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 are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Key Responsibilities:

Attaching faxes for chart reviews for the nursing team

Answering departmental phones as assigned

Make outbound calls to engage members and/or providers to verify clinical information/discharge date and admission status

Document calls and attach clinical information received

Request clinical information from providers/facilities

Create and send out written correspondence

Ability to multitask and prioritize

Collaborate with multiple roles/departments/providers/team members

Required Qualifications

1 or more years of years of administrative, telephonic customer service and/or healthcare experience

Excellent verbal and written communication skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Comprehensive knowledge of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems

Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Proficient utilizing electronic medical record and documentation programs

Proficient and/or experience with medical terminology and/or ICD-10 codes

Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Additional Information

Hours for this role are: Monday-Friday 8am-5pm CST

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire Text/Voice to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Internal Only- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com