Appeals Back End UM Admin Coordinator

Humana Inc; Frankfort (KY); On-site; USD 39,000 - 49,000; Full time

Benefits offered by this job

Remote work

Healthcare benefits

401(k)

Job summary

Humana Inc. seeks a UM Administration Coordinator to support utilization management operations.

You will perform administrative tasks, manage information, and coordinate communications with internal teams and external stakeholders to ensure timely, accurate processing of member care requests. Working under general supervision, you will prioritize tasks, maintain quality, and help improve member experiences while adhering to policies and HIPAA requirements.

Qualifications

• Experience providing administrative, operational, customer service, or technical support in a professional environment.
• Strong verbal and written communication skills with the ability to interact effectively with diverse audiences.
• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook, and the ability to learn new systems and technologies.
• Ability to work independently in a remote environment and maintain a reliable internet connection that meets company requirements.
• Strong organizational skills, attention to detail, and ability to manage multiple priorities in a fast-paced setting.
• Commitment to delivering exceptional service and contributing to a culture focused on improving customer and member experiences.

Responsibilities

• Provide administrative support for utilization management (UM) programs and processes.
• Review, process, and maintain information and records accurately and in a timely manner.
• Coordinate communications with internal teams and external stakeholders.
• Support operational activities that help facilitate appropriate care and service delivery for members.
• Follow established policies, procedures, and work instructions to complete assigned tasks.
• Prioritize workload, maintain quality standards, and meet performance expectations.
• Collaborate effectively with team members to support departmental and business objectives.
• Perform work under general supervision, exercising judgment within established guidelines.

Skills

Administrative experience

Communication skills

MS Office proficiency

Remote work capability

Organizational skills

Customer service

Education

Associate's or bachelor's degree in Business, Healthcare Administration, Finance, or related field

Tools

Microsoft Office

Job description

Become a part of our caring community

The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.

UM Administration Coordinator

The UM Administration Coordinator provides administrative support for utilization management operations and processes. This role reviews and processes information, maintains records, performs data entry, and supports communications with internal and external stakeholders. Working within established policies and procedures, the coordinator completes routine assignments, ensures accuracy and timeliness, and contributes to the efficient delivery of utilization management services. Work is performed under general supervision with guidance provided for non-routine situations.

As a UM Administration Coordinator, you will:

• Provide administrative support for utilization management (UM) programs and processes.

• Review, process, and maintain information and records accurately and in a timely manner.

• Coordinate communications with internal teams and external stakeholders.

• Support operational activities that help facilitate appropriate care and service delivery for members.

• Follow established policies, procedures, and work instructions to complete assigned tasks.

• Prioritize workload, maintain quality standards, and meet performance expectations.

• Collaborate effectively with team members to support departmental and business objectives.

• Perform work under general supervision, exercising judgment within established guidelines.

Use your skills to make an impact

Required Qualifications

• Experience providing administrative, operational, customer service, or technical support in a professional environment.

• Strong verbal and written communication skills with the ability to interact effectively with diverse audiences.

• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook, and the ability to learn new systems and technologies.

• Ability to work independently in a remote environment and maintain a reliable internet connection that meets company requirements.

• Strong organizational skills, attention to detail, and ability to manage multiple priorities in a fast-paced setting.

• Commitment to delivering exceptional service and contributing to a culture focused on improving customer and member experiences.

Preferred Qualifications

• Experience using electronic medical record (EMR), healthcare documentation, or case management systems.

• Familiarity with medical terminology, healthcare coding, or ICD-10 classifications.

• Associate's or bachelor's degree in Business, Healthcare Administration, Finance, or a related field.

• Prior customer service, member service, or call center experience.

• Experience supporting Utilization Management, Prior Authorization, Care Management, or related healthcare operations, preferably within a health plan or managed care environment.

Additional Information

Interview Process:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Work at home requirements:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• 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.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$39,000 - $49,400 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.