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Humana - Boise, ID
posted 2 months ago
Full-time
Hybrid - Boise, ID
Insurance Carriers and Related Activities
About the position
The UM Administration Coordinator 2 plays a vital role in the administration of utilization management at Humana. This position involves performing a variety of moderately complex administrative and operational tasks to support the organization's goals of providing the best treatment and care for members. The coordinator will work under minimal direction, following established policies and practices while having some discretion in prioritizing tasks and managing workflows.
Responsibilities
- Answer departmental phones as part of the UM process.
- Make inbound/outbound calls daily to providers to schedule peer-to-peer consultations.
- Manage queues and assign cases effectively.
- Process QIO Appeals in a timely manner.
- Create and send out written correspondence to relevant parties.
- Demonstrate the ability to multitask and prioritize in a high production environment.
- Collaborate with multiple roles, departments, providers, and team members.
Requirements
- 1 or more years of administrative, telephonic customer service, and/or healthcare experience.
- Excellent verbal and written communication skills.
- Comprehensive knowledge of Microsoft Word, Outlook, and Excel with the ability to type and enter data accurately.
- Ability to quickly learn new systems and processes.
- Passion for contributing to an organization focused on improving consumer experiences.
Nice-to-haves
- Proficient in utilizing electronic medical record and documentation programs.
- Experience with medical terminology and/or ICD-10 codes.
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
