Telephonic UM Administration Coordinator

Humana; United States; Remote; USD 40,000 - 53,000; Full time

Job summary

Join a leading healthcare company as a Telephonic UM Administration Coordinator, providing essential non-clinical support to ensure quality treatment for members. Collaborate with various departments while managing calls and documentation. This role offers a structured schedule and opportunities for professional growth within a supportive environment.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401(k)

Paid Time Off

Disability Insurance

Life Insurance

Qualifications

• 1 year of administrative support and healthcare experience.
• 1 year of telephonic customer service experience.

Responsibilities

• Receive calls from providers and support UM nurses.
• Document calls and requests accurately.
• Research Medicare and Medicaid guidelines.

Skills

Administrative Support

Customer Service

Communication

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Telephonic UM Administration Coordinator

Join Our Caring Community and Help Put Health First

The UM Administration Coordinator 2 provides non-clinical support to ensure the delivery of appropriate treatment, care, or services for members, following established policies and procedures.

Key Responsibilities

• Receive calls from Providers, Hospitals, Skilled Nursing Facilities, and other vendors.
• Support UM Nurses in processing discharge orders and arranging safe discharges.
• Collaborate with UM Nurses, Pharmacy, Medical Directors, and other departments.
• Make follow-up calls during downtime to relevant contacts.
• Document all calls and requests accurately.
• Research Medicare and Medicaid Guidelines.
• Process all incoming fax/email requests for services on the same day.
• Return calls for all voice messages received promptly.
• Handle provider and member correspondence, including Letters of Agreement, Approvals, and Denials.
• Mail letters to members as needed.
• Assist with various clerical and administrative tasks.
• Participate in special projects as assigned by supervisors or managers.

Use Your Skills to Make an Impact

Required Qualifications

• At least 1 year of administrative support experience.
• At least 1 year of healthcare experience.
• At least 1 year of telephonic customer service experience.
• Proficiency in Microsoft Word, Excel, and Outlook.
• Availability to work Monday-Friday, 8 am-5 pm EST, with flexibility for nights, weekends, and holidays based on business needs.

Preferred Qualifications

• Bilingual in English and Spanish (spoken, read, and written).
• Experience with documentation programs and the CarePlus Platform.
• Knowledge of medical terminology and ICD-10 codes.
• Experience with Utilization Review and/or Prior Authorization within a managed care setting.

Additional Information

Work Schedule: Monday-Friday 8 am-5 pm EST, with one weekend per quarter. Schedule may vary based on business needs.

We utilize HireVue for interviews, which may include pre-recorded voice and SMS text responses, each approximately 5-15 minutes.

Work at Home Guidance

• Internet speed of at least 25 Mbps download and 10 Mbps upload is recommended.
• Wireless, wired cable, or DSL connections are preferred; satellite or cellular only with approval.
• Home in CA, IL, MT, SD may receive internet expense reimbursement.
• Humana provides necessary telephone equipment.
• Work from a dedicated, interruption-free space to protect member information.

For questions, contact the Ask A Recruiter persona via go/vivaengage, including the requisition number.

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Travel: Occasional travel to Humana offices may be required.

Scheduled Weekly Hours: 40

Pay Range: $40,000 - $52,300 annually, based on location and experience.

Benefits

Humana offers comprehensive benefits including medical, dental, vision, 401(k), paid time off, disability, life insurance, and more.

About Us

CarePlus Health Plans, a Humana subsidiary, has over 23 years of Medicare Advantage experience in Florida. Humana is committed to health and wellness for all.

Equal Opportunity Employer

Humana promotes diversity and inclusion, providing equal employment opportunities regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or genetic information.

About the Company

Humana works to create personalized health paths for individuals, considering all aspects of their lives.