[Remote] UM Administration Coordinator

Note: The job is a remote job and is open to candidates in USA. Humana Inc. is a leading U.S. healthcare company seeking a UM Administration Coordinator to contribute to the administration of utilization management. The role involves processing authorization requests, maintaining records, and collaborating with care teams to ensure appropriate treatment for members.

Responsibilities

• Accurately and efficiently process and enter authorization requests into the system
• Review care team submitted service requests and validate required documentation before processing
• Coordinate follow-up with the care team for missing or additional required information
• Maintain detailed records of authorization approvals, denials, and modifications
• Collaborate with UM nurses and care teams to escalate requests requiring additional clinical review
• Monitor authorization timelines and turnaround times to prevent delays
• Serve as a liaison between providers, members, and internal teams, ensuring smooth communication regarding service approvals
• Identify potential discrepancies, errors, or inefficiencies and work proactively to resolve them
• Assist with training and onboarding of new team members as needed

Skills

• 1 or more years administrative or technical support experience
• Excellent verbal and written communication skills
• Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
• Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Proficient utilizing electronic medical record and documentation programs
• Proficient and/or experience with medical terminology and/or ICD-10 codes
• Bachelor's Degree in Business, Finance or a related field
• Prior member service or customer service telephone experience desired
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Benefits

• 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

Company Overview

Company H1B Sponsorship