Utilization Management Coordinator – Home Health

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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This company has sponsored H1B visas in the past.

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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

• Support the administration of utilization management through moderately complex administrative, operational, and customer service tasks • Interact by telephone with providers, members, and other stakeholders • Receive inbound calls and provide customer service • Support intake of utilization management and prior authorization requests • Create and process authorization cases • Generate letters and other correspondence • Triage faxes and shared mailboxes • Process, review, and route documentation • Conduct calculations and data processing • Provide non-clinical support for utilization management policies and procedures • Respond to provider and member questions • Navigate multiple systems while documenting interactions and processing information • Prioritize assignments and work with minimal direction • Adapt between telephonic and non-telephonic functions as business needs and operational priorities change

🎯 Requirements

• 1 or more years of administrative, technical support, customer service, or related experience • Excellent verbal and written communication skills • Ability and willingness to provide customer service and intake support through high-volume inbound telephone interactions • Ability to simultaneously communicate by telephone, navigate multiple systems/screens, accurately document interactions, and process information • Working knowledge of MS Office, including Word, Excel, and Outlook, in a Windows-based environment • Ability to quickly learn new systems • Accessibility to high-speed DSL or cable modem 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 lacking ongoing interruptions to protect member PHI/HIPAA information • Ability to adapt to changing work assignments based on business and operational needs • Ability to work between 8 a.m. and 8 p.m. EST • Availability for rotational weekend work • Preferred: proficiency with electronic medical record and documentation programs • Preferred: proficiency and/or experience with medical terminology and/or ICD-10 codes • Preferred: Bachelor's degree in Business, Finance, or a related field • Preferred: prior member, provider, call center, or customer service telephone experience • Preferred: experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

🏖️ Benefits

• Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Remote work arrangement • Occasional travel to Humana offices for training or meetings • Dedicated home office space • High-speed home internet requirement/support for remote work

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