Responsibilities

The Home Solutions UM/NM Team is hiring for a UM Administration Coordinator 2 that will provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members utilizing home health services. This team sits in the Home Solutions organization and contributes to the Value-Based segment partnering with Kindred At Home/CenterWell and onehome.

The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.

Key Responsibilities:

• Attaching faxes for chart reviews for the nursing and medical team

• Answering departmental phones as assigned

• Make outbound calls to engage members and/or providers to verify clinical information/discharge date and admission status

• Document calls and attach clinical information received

• Request clinical information from providers/facilities

• Create and send out written correspondence

• Ability to multitask and prioritize

• Collaborate with multiple roles/departments/providers/team members

Required Qualifications

• 1 or more years of Administrative support or telephonic Customer Service experience in a healthcare environment
• Excellent verbal and written communication skills
• Working knowledge of MS Office Word and Excel in a Windows based environment and an ability to quickly learn new systems

Preferred Qualifications

• CGX experience with building cases and generating letters
• Experience triaging high volume fax boxes
• Proficient utilizing electronic medical record and documentation programs
• Proficient and/or experience with medical terminology and/or ICD-10 codes
• Prior telephonic member service experience
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
• Proficient in Microsoft Outlook

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours