UM Administration Coordinator - Healthcare

Humana • Schaumburg, IL

1d • Hybrid

About The Position

The UM Administration Coordinator 2 contributes to the administration of utilization management and performs varied activities and moderately complex administrative, operational, and customer support assignments. This role involves performing computations and typically working on semi-routine assignments. The Coordinator also contributes to the administration of care management by providing non-clinical support for the assessment and evaluation of members' needs and requirements. The goal is to help members and their families achieve and maintain optimal wellness by guiding them toward and facilitating interaction with appropriate resources. Decisions are primarily focused on interpreting area/department policy and determining methods for completing assignments. The coordinator works within defined parameters to identify work expectations and quality standards, with some latitude over prioritization and timing, and follows standard policies that allow for some interpretation or deviation.

Requirements

• Must reside in the Greater Chicago area/suburban Cook or nearby surrounding counties in the State of Illinois
• 2+ years of administrative support experience in the healthcare industry
• 1+ years of customer service experience
• Previous experience working with Medicaid, Long-term Care, or Medicare members

Nice To Haves

• A minimum of an Associate's degree
• Prior billing/claims or authorization experience
• Proficient using electronic medical record and documentation programs
• Proficient with medical terminology and ICD-10 codes
• Experience with Utilization Review and Prior Authorization within a managed care organization

Responsibilities

• Contributes to administration of utilization management
• Performs varied activities and moderately complex administrative/operational/customer support assignments
• Perform computations
• Contributes to the administration of care management
• Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and maintain optimal wellness
• Guides members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
• Identifies work expectations and quality standards within defined parameters
• Follows standard policies that allow for some opportunity for interpretation/deviation

Benefits

• medical benefits
• dental benefits
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term disability
• long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees