Administrative Coordinator

1 week ago


Madison, Wisconsin, United States Humana Full time
Job Summary

We are seeking a highly organized and detail-oriented Administrative Coordinator to join our team at Humana. As an Administrative Coordinator, you will provide clerical support for our department, ensuring the smooth operation of our utilization management processes.

Key Responsibilities
  • Manage NLP's for chart reviews for the nursing team
  • Build and pend authorizations for review
  • Responsible for inbound and outbound calls to engage providers and members to verify clinical information/discharge date and admission status throughout the day
  • Document calls and attach clinical information received
  • Request clinical information from providers/facilities
  • Create and send out written correspondence
  • Create and distribute determination letters
  • Collaborate with multiple roles/departments/providers/team members
Requirements
  • 1+ years' experience working in an administrative support capacity
  • Prior professional experience of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately
  • Ability to quickly learn new systems (proficient to advanced)
Preferred Qualifications
  • Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
  • 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 desired
  • Experience with SNF and/or Home Health
  • Prior experience with CGX, SRO and HCHB
  • Prior experience in a metric driven environment
  • Prior experience in the healthcare industry
Work Environment

This is a remote position with the possibility of flexible working hours Monday to Friday between 8am and 8pm EST (8 paid hours per business day). Overtime is available based on business needs, and weekend and/or holiday work may be required for this role.

Benefits

Humana offers a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and many other opportunities. We are an equal opportunity employer and value diversity and inclusion in the workplace.



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