Remote Utilization Management Coordinator

Humana, Inc.; Madison (WI); Teletrabalho; USD 40 000 - 52 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Remote work

Travel occasionally

Resumo da oferta

Humana, Inc. is seeking an UM Administration Coordinator to support UM operations with provider and member phone support and back-office tasks while teleworking.

You will handle 30–50 calls daily, complete documentation, collaborate with clinical and operational teams, and participate in mandatory training. The role requires reliable internet, a dedicated workspace, and flexibility to cover weekends and holidays.

Qualificações

• Minimum of 2 years of customer service experience.
• Experience managing a high-volume of calls (30–50 daily) across multiple systems.
• Typing proficiency of at least 30 words per minute.
• Proficient in Microsoft Office.
• Requires wired internet connection; no Wi-Fi.
• Dedicated, distraction-free workspace with webcam.

Responsabilidades

• Handle inbound and outbound calls about prior authorizations, utilization management services, and benefits; ~30–50 phone interactions daily when on 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 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.

Conhecimentos

Customer service

Phone support

High-volume calls

Remote work

Attention to detail

Data entry

Ferramentas

Microsoft Office

EMR systems

Descrição da oferta de emprego

Humana, Inc. is seeking an UM Administration Coordinator to support UM operations with provider and member phone support and back-office tasks while teleworking.

You will handle 30–50 calls daily, complete documentation, collaborate with clinical and operational teams, and participate in mandatory training. The role requires reliable internet, a dedicated workspace, and flexibility to cover weekends and holidays.