The 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.
Responsibilities
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. The associate could be assigned authorizations from various providers to determine approved or if it needs to be submitted for clinical review. The associate will follow standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Typical Responsibilities:
working authorizations from provider offices
potential to contact offices inquiring for documentation
will review authorization requests and determine if can approve or send for clinical review
Required Qualifications
High School Diploma
1 or more years of experience in medical field
Excellent verbal and written communication skills
Working 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 10Mx1M
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
This position is temporary Work At Home due to Covid. This position has the potential to reenter the office when it is deemed safe to do so
Reasonable distance to Miami, FL
This position does have rotational weekends amongst the team, must be willing to work a Saturday 8 to 5, Sunday 8 to 12pm.
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 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
Additional Information
Temporary Work at home due to Covid-potential to reenter the office
Scheduled Weekly Hours
40
To apply for this job please visit www.humana-spain.org.
