UM Administration Coordinator - Correspondence

Company: Humana
Location: San Antonio
Posted on: January 27, 2023

Job Description:

Description

The UM Administration Coordinator 3 contributes to administration of utilization management. The UM Administration Coordinator 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

Responsibilities

The UM Administration Coordinator 3 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. Specifically, p repares letters to members and providers regarding approvals, adverse determinations and appeals following CMS, NCQA and provider contract guidelines. Assists with coordinating peer to peers.

Required Qualifications
3 or more years Administrative or technical support experience
Excellent verbal and written communication skills
Advanced knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
Proficient utilizing electronic medical record and documentation programs
Proficient and/or experience with medical terminology and/or ICD-10 codes
Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications
Bachelor's Degree in Business, Finance or a related field
Prior member service or customer service telephone experience desired
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Additional Information
As part of our hiring process for this opportunity, we will be using a technology called Montage Voice which allows us to quickly connect and gain valuable information from you about your relevant experience.
If you are selected for a phone screen you will receive an email inviting you to participate in a Montage Voice interview. During this call you will be asked a set of questions pertaining to this particular role and you will provide recorded responses. The entire process takes about 15-20 minutes and can be done at your convenience. Your responses will be reviewed and you will be informed if you were selected for an in person or video interview, depending on your location.

Scheduled Weekly Hours

40

Keywords: Humana, San Antonio , UM Administration Coordinator - Correspondence, Other , San Antonio, Texas