Remote Utilization & Prior Authorization Coordinator

Humana; United States; À distance; USD 40 000 - 52 000; Plein temps

Résumé du poste

Humana is seeking an UM Administration Coordinator to support utilization management operations remotely. The role involves handling member/provider calls, processing prior authorizations, and performing back-office administrative tasks with strict adherence to processes.

You'll work 40 hours per week with weekend and holiday rotation, undergoing a training period from 8:00 AM to 4:30 PM CST. Strong customer service and healthcare knowledge are preferred.

Qualifications

• Minimum of 2 years of customer service experience.
• Experience handling a high volume of calls (30–50 daily).
• Typing proficiency of at least 30 words per minute.
• Proficient with Microsoft Office tools and features.
• Wired internet connection required; Wi‑Fi not permitted.

Responsabilités

• Handle inbound and outbound calls about prior authorizations, utilization management services, and benefits; ~30–50 calls daily for phone support.
• Process and review prior authorization requests and documentation to support medical necessity determinations.
• 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 interactions and research findings.
• Complete and monitor assigned work queues to meet service levels and turnaround times.
• Collaborate with clinical and operational teams to resolve issues and address escalated concerns.

Connaissances

Customer service

Phone support

Microsoft Office

Typing 30 wpm

Wired internet connection

Outils

EMR systems

Description du poste

Humana is seeking an UM Administration Coordinator to support utilization management operations remotely. The role involves handling member/provider calls, processing prior authorizations, and performing back-office administrative tasks with strict adherence to processes.

You'll work 40 hours per week with weekend and holiday rotation, undergoing a training period from 8:00 AM to 4:30 PM CST. Strong customer service and healthcare knowledge are preferred.