Remote UM Coordinator - Prior Authorization & Admin

Humana, Inc.; Juneau (AK); Remote; USD 40,000 - 52,000; Full time

Job summary

Humana, Inc. is seeking a remote UM Administration Coordinator to support utilization management operations with provider and member-facing phone support and back-office tasks.

The role reports to the Supervisor, UM Management and requires strong customer service, high-volume call handling (30–50 calls daily), 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 a high-volume of calls (approximately 30 to 50 calls daily) using multiple computer systems.
• Typing proficiency of at least 30 words per minute.
• Proficient experience using Microsoft Office (including toolbars, menus, and system features to locate documents).
• A direct wired connection to an internet router is required (Wi-Fi is not permitted).
• A dedicated, distraction-free, professional workspace with a closed door (webcam for meetings and training).

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 when assigned to phone support.
• 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, process flows, and work instructions.
• 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

Phone support

Typing

Microsoft Office

Wired internet

Home workspace

Tools

Electronic medical records (EMR)

Job description

Humana, Inc. is seeking a remote UM Administration Coordinator to support utilization management operations with provider and member-facing phone support and back-office tasks.

The role reports to the Supervisor, UM Management and requires strong customer service, high-volume call handling (30–50 calls daily), and proficiency with Microsoft Office. A wired internet connection and a distraction-free home workspace are required.