Remote UM Coordinator: Prior Authorization & Member Support

Humana, Inc.; Providence (RI); Teletrabalho; USD 40 000 - 52 000; Tempo integral

Resumo da oferta

Humana, Inc. is seeking a UM Administration Coordinator to support UM operations via provider and member-facing phone support and back-office administrative responsibilities.

This is a remote role reporting to the Supervisor, UM Management, with shifts ending by early evening and one weekend day plus holiday rotation. The role includes handling calls about prior authorizations, reviewing documentation, performing back-office tasks, and collaborating with clinical teams to resolve issues.

Qualificações

• Minimum of 2 years of customer service experience.
• Experience handling a high volume of calls (30–50 daily) across multiple systems.
• Typing proficiency of at least 30 words per minute.
• Proficient use of Microsoft Office tools and features.
• Direct wired internet connection required (no Wi‑Fi).
• Dedicated, distraction-free workspace with webcam for meetings/training.

Responsabilidades

• Handle inbound and outbound calls about prior authorizations, utilization management, and benefits for providers and members (30–50 calls daily when on phone support).
• Process and review prior authorization requests and determine medical necessity per workflows.
• Perform back-office administrative tasks: case research, record updates, error resolution, timely processing.
• Review, verify, and enter information across systems; document interactions and findings per procedures.
• Manage work queues to meet SLAs and turnaround times.
• Collaborate with clinical and operational teams to resolve issues and address escalations.

Conhecimentos

Customer service

High-volume calls

Typing 30 wpm

MS Office

Wired internet

Dedicated workspace

Remote training

Ferramentas

Electronic medical records

Documentation programs

Descrição da oferta de emprego

Humana, Inc. is seeking a UM Administration Coordinator to support UM operations via provider and member-facing phone support and back-office administrative responsibilities.

This is a remote role reporting to the Supervisor, UM Management, with shifts ending by early evening and one weekend day plus holiday rotation. The role includes handling calls about prior authorizations, reviewing documentation, performing back-office tasks, and collaborating with clinical teams to resolve issues.