UM Administration Coordinator

Humana • Carapichaima, SC

2d • $40,000 - $52,300 • Hybrid

About The Position

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.

Requirements

• 1+ year in administrative experience in a healthcare setting.
• Working knowledge of MS Office including Word, Excel, and Outlook

Nice To Haves

• 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

Responsibilities

• 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
• 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

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level