Remote Prior Authorization Specialist

Humana; Kentucky; 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.

The role emphasizes collaboration in a remote environment, leveraging Microsoft Office and EMR/documentation systems while delivering quality member outcomes within Humana's Medicaid UM team.

Qualifications

• 1+ year of administrative experience in a healthcare environment.
• Proficient with Microsoft Office (Word, Excel, Outlook) on Windows.
• Comfortable learning and using new systems and tools.

Responsibilities

• Manage and organize documentation for prior authorization requests.
• Enter data accurately into the clinical documentation system.
• Research participating status to ensure Humana policy compliance.
• Verify member eligibility and benefits for prior authorization requests.

Skills

Admin experience

MS Office

Tech savviness

Tools

EMR systems

Documentation software

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.

The role emphasizes collaboration in a remote environment, leveraging Microsoft Office and EMR/documentation systems while delivering quality member outcomes within Humana's Medicaid UM team.