HCPR-Prior Authorizations

Profile

Description

The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.

Responsibilities

The UM Administration Coordinator 1 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are limited to defined parameters around work expectations, quality standards, priorities and timing, and works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation.

Assignment:

Processing prior authorizations and inputting the clinical information that the providers have sent. Data entry such as adding member and provider information and answering clinical questions.

Required Qualifications

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

Preferred Qualifications

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

Additional Information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com