UM Administration Coordinator

Become a part of our caring community   The UM Administration Coordinator, National Medicaid Clinical Operations is responsible for providing administrative support to the National Medicaid Clinical Operations Authorization Team. This role involves managing documentation, coordinating communication, and ensuring the smooth operation of prior authorization processes. The Administration Coordinator works closely with clinical and nonclinical staff to facilitate timely and accurate prior authorization decisions. Administrative Support: •    Manage and organize documentation related to prior authorization requests, including clinical requests and receipt of clinicals •    Maintain accurate records and ensure timely data entry into the clinical documentation system •    May work from reports to conduct data entry into the clinical documentation system for the team •    Research participating status to ensure compliance with Humana policies •    Verify member eligibility and benefits for prior authorization requests   Communication and Coordination: •    Serve as a point of contact for internal and external stakeholders regarding prior authorization inquiries •    Coordinate communication between healthcare providers and the prior authorization team •    Collaborate with team members to ensure seamless integration of prior authorization processes Use your skills to make an impact   Required Qualifications 1+ year in administrative experience in a healthcare setting. Working knowledge of MS Office including Word, Excel, and Outlook 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 Prior member service or customer service telephone experience desired Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.   Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.   Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.   $40,000 - $52,300 per year   Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions