Remote Medicaid Compliance Coordinator (UM)

Humana; South Carolina; Remote; USD 43,000 - 56,000; Full time

Job summary

Humana is seeking a Compliance (UM) Coordinator to issue adverse benefit determination letters for Medicaid UM determinations, ensuring adherence to accreditation and contractual requirements. This role works independently to meet production and quality metrics while supporting team compliance.

The position is remote with occasional travel to Humana offices for training or meetings. Hours are 40 per week, with a compensation range of $43,000–$56,200 per year.

Qualifications

• 1+ year of experience in healthcare or related field.
• 1+ year of data entry experience.
• Proficiency in Microsoft Office applications, including Word, Excel and Outlook.

Responsibilities

• Generates notice of adverse benefit determination and approval letters for Medicaid UM determinations in compliance with requirements.
• Works independently while meeting production and quality metrics.
• Collaborates with teammates to ensure overall team success and compliance.
• Analyzes report data daily, weekly, monthly to identify trends posing compliance risks.
• Work hours will be business hours in EST with rotating schedule for weekends/holidays.

Skills

Healthcare experience

Data entry

MS Office

Job description

Humana is seeking a Compliance (UM) Coordinator to issue adverse benefit determination letters for Medicaid UM determinations, ensuring adherence to accreditation and contractual requirements. This role works independently to meet production and quality metrics while supporting team compliance.

The position is remote with occasional travel to Humana offices for training or meetings. Hours are 40 per week, with a compensation range of $43,000–$56,200 per year.