Bilingual Compliance UM Coordinator

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $43k - $56.2k / year

⏰ Full Time

🟢 Junior

🚔 Compliance

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Review utilization management activities and documentation for adherence to policies, procedures, and regulations • Collect and analyze daily, weekly, monthly, or ad hoc data to assess team and individual outcome and operational metrics • Interpret guidelines and independently determine appropriate courses of action • Process QIO fast-track appeals and expedited authorization requests according to established guidelines and regulatory turnaround times • Follow department, segment, and organizational strategies and operating objectives • Make decisions regarding work methods in occasionally ambiguous situations • Work with minimal direction and receive guidance where needed • Protect member PHI/HIPAA information while working from home

🎯 Requirements

• 1–3 years of technical experience • Proficient in Microsoft Word and Excel • Strong attention to detail and accuracy • Passion for contributing to an organization focused on continuously improving consumer experiences • Excellent verbal and written communication skills • Clerical support background in a healthcare environment • Ability to work independently in an agile environment under general instructions and within a team • Bilingual in English and Spanish with full professional proficiency; able to successfully pass required examinations • Ability to work schedules between Monday and Sunday, 8 am to 8 pm EST • Ability to provide high-speed DSL or cable modem internet for a home office; satellite and wireless internet are not allowed • Minimum internet speed of 25 Mbps download and 10 Mbps upload • Dedicated office space without ongoing interruptions to protect member PHI/HIPAA information • UM experience with auditing or compliance (preferred) • UM experience processing expedited requests or QIO appeals (preferred) • Familiarity with medical terminology and/or ICD-10 codes (preferred) • Associate's or Bachelor's degree in Healthcare, Business, Finance, or related field (preferred)

🏖️ Benefits

• Medical, dental, and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Flexible schedule • Four-day workweek with ten-hour shifts • Occasional overtime • Remote work arrangement • Training and meetings travel opportunities