Humana

About Humana

 

Job Category:

Member Quality & Financials - Utilization Management

Country:

United States

Postal Code:

75014

Approximate Salary:

Not Specified

Position Type:

Full Time

UM Administration Coordinator 1 VSP temp

Humana - Irving, Texas

Posted: 11/11/2018

Description

The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.

Responsibilities

The UM Administration Coordinator 1 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.

Duties include:

  • Creation of prior authorizations following company's processes from online sources.
  • Use of attention to detail to provide accurate data entry and timely resolutions for authorizations requests.
  • Build lasting relationships with Humana's customers via outbound calls when needed: Physician offices and Pharmacies.

               

Required Qualifications

  • High School Diploma 
  • Administrative or technical support experience 
  • Excellent verbal and written communication skills 
  • Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems 
  • Must be able to work any shift between the hours of 8:00 am - 8:00 pm Monday-Saturday.  Potential overtime during peak season as well as when business needs require

Preferred Qualifications

Proficient utilizing electronic medical record and documentation programs

Proficient and/or experience with medical terminology and/or ICD-10 codes

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 

Scheduled Weekly Hours

40

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