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. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
- High School Diploma or equivalent.
- 1+ years administrative or Call Center experience.
- Excellent verbal and written communication skills in English/Spanish
- Fully Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. If selected for the position, you will be required to take a Language Proficiency Assessment in English/Spanish. See Additional Information on testing
- Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment.
- Ability to quickly learn new systems.
Work At Home requirements (temporary due to Covid-19): Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- 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.
- Prior member service or customer service telephone experience.
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
Schedule: Monday to Friday from 8 am to 5 pm, Overtime, needed to work some weekends
Training: 4-6 weeks Virtual
Work Location (Address): This permanent job is working from Home temporary due to Covid 19 emergency. This position will deploy to the following location at a future date: 11430 N W 20th Street. Suite 300. Miami, FL 33172
Language Proficiency Testing: Any Humana associate who speaks with a member in a language other than Spanish and/or English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
Scheduled Weekly Hours