Remote Healthcare Utilization Admin Coordinator

Humana; Michigan; On-site; USD 40,000 - 52,000; Full time

Job summary

Humana is seeking a detail-oriented UM Administration Coordinator 2 to support the prior authorization process by managing clinical documentation, verifying member eligibility and benefits, and ensuring timely processing of requests. This role offers remote work and the chance to contribute to positive member outcomes within Humana's Medicaid UM team.

You will organize documentation, enter data into the clinical systems, research status for compliance, and verify benefits for authorization

Qualifications

• 1+ year of administrative experience in a healthcare environment.
• Proficient in Word, Excel, and Outlook in Windows.
• Comfortable learning and using new systems, tools, and technology.

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

Admin experience

Tools

Microsoft Office

Job description

Humana is seeking a detail-oriented UM Administration Coordinator 2 to support the prior authorization process by managing clinical documentation, verifying member eligibility and benefits, and ensuring timely processing of requests. This role offers remote work and the chance to contribute to positive member outcomes within Humana's Medicaid UM team.

You will organize documentation, enter data into the clinical systems, research status for compliance, and verify benefits for authorization