Remote UM Coordinator - Prior Auth & Support

Humana, Inc.; Columbus (OH); Remote; USD 40,000 - 52,000; Full time

Job summary

Humana, Inc. is hiring a UM Administration Coordinator to support utilization management operations remotely. The role includes phone support, back-office tasks, and collaboration with clinical teams. Training is conducted on a full-time schedule during the first month.

We expect strong customer service experience, the ability to manage high call volumes, and proficiency with Microsoft Office. A wired internet connection and a distraction-free home workspace are required.

Qualifications

• Minimum of 2 years of customer service experience.
• Experience managing 30–50 calls daily across multiple computer systems.
• Typing proficiency of at least 30 words per minute.
• Proficient experience using Microsoft Office.
• A direct wired connection to an internet router is required.
• A dedicated, distraction-free, professional workspace with a closed door and webcam.

Responsibilities

• Handle inbound and outbound calls about prior authorizations, utilization management services, and benefits; help providers and members navigate these processes, with approximately 30 to 50 phone interactions daily.
• Process and review prior authorization requests and documentation, researching and evaluating information to support medical necessity determinations and authorization workflows.
• Perform back-office administrative tasks, including case research, record updates, error resolution, and timely case processing.
• Review, verify, and enter accurate information across multiple systems; document all interactions, research findings, and case activities while following established procedures.
• Complete and monitor assigned work queues to meet service level agreements and turnaround time requirements.
• Collaborate with clinical and operational teams and internal partners to resolve issues and address escalated concerns.

Skills

Customer service

High call volume

Typing 30 wpm

MS Office

Wired internet

Home office

Tools

Microsoft Office

Job description

Humana, Inc. is hiring a UM Administration Coordinator to support utilization management operations remotely. The role includes phone support, back-office tasks, and collaboration with clinical teams. Training is conducted on a full-time schedule during the first month.

We expect strong customer service experience, the ability to manage high call volumes, and proficiency with Microsoft Office. A wired internet connection and a distraction-free home workspace are required.