Medicaid Claims Administration Coordinator (UM, UR, PA)

Become a part of our caring community   The UM Administration Coordinator 2 contributes to administration of utilization management for Humana's KY Medicaid plan. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Perform computations. Typically work on semi-routine assignments. The UM Administration Coordinator 2 provides non-clinical support for the procedures ensuring best treatment, care or services for members. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Work within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing. Follow standard policies that allow for some opportunity for interpretation/deviation and independent. Use your skills to make an impact   Required Qualifications 2+ years of experience in medical claims. 1+ years of Medicaid experience. 2+ years of experience with Utilization Review (UR) and/or Prior Authorization (PA) processes within a managed care organization. 2+ years of administrative experience or experience in a similar healthcare, insurance, or managed care role. Working knowledge of MS Office including Word, Excel, and Outlook in a Windows-based environment and an ability to quickly learn new systems.

Proficient using electronic medical record and documentation programs. Proficient or experience with medical terminology or ICD-10 codes. Prior member service or customer service telephone experience.

Schedule/Time Zone: Monday through Friday, 8:00 AM – 5:00 PM ET or CT zone with flexibility to work overtime. Work Location: US Nationwide (Stateside) Work Style: Remote 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 of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a