UM Administration Coordinator

Humana • Schaumburg, IL

3d • $44,000 - $57,500 • Hybrid

About The Position

Become a part of our caring community and help us put health first Join the IL Medicaid Utilization Management (UM) team as a UM Administration Coordinator, reporting to the UM Administration Supervisor, where your work directly impacts the quality of care for our members. In this role, you will collaborate with other professionals, contribute to the smooth administration of utilization management processes, and handle an array of administrative and operational tasks. Use your skills to help ensure members receive the most appropriate treatment and services. Provide non-clinical support for policies and procedures ensuring the best and most appropriate treatment, care or services for members. Review cues, reports, and outlook inboxes for information from providers to build authorizations for services for dual eligible members. Use a variety of both Humana and State of Illinois programs and websites to review member information and eligibility. Make decisions focused on interpretation of department policy and methods for completing assignments. Follow standard policies and practices that allow for some opportunity for interpretation or independent decisions. Use your skills to make an impact

Requirements

• Must reside in the Greater Chicago area/suburban Cook or nearby surrounding counties in the State of Illinois.
• 2+ years of experience in the healthcare industry.
• Previous experience working with Medicaid, Long Term Care, or Medicare.
• Experience with Microsoft Office programs specifically Word, Excel, Outlook.

Nice To Haves

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

Responsibilities

• Provide non-clinical support for policies and procedures ensuring the best and most appropriate treatment, care or services for members.
• Review cues, reports, and outlook inboxes for information from providers to build authorizations for services for dual eligible members.
• Use a variety of both Humana and State of Illinois programs and websites to review member information and eligibility.
• Make decisions focused on interpretation of department policy and methods for completing assignments.
• Follow standard policies and practices that allow for some opportunity for interpretation or independent decisions.

Benefits

• Humana provides medical, dental and 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 and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree