UM Administration Coordinator
Humana
Job Summary
Humana is hiring a remote UM Administration Coordinator to process authorization requests, validate documentation, track approvals and denials, and support utilization management operations for Humana Healthy Horizons in Indiana.
Job Description
The UM Administration Coordinator supports Humana’s utilization management process by handling non-clinical authorization processing, entering service requests, reviewing submitted documentation, tracking approval and denial activity, and helping ensure authorization timelines are met. This role works with members, providers, UM nurses, care coordinators, and internal teams to support accurate and timely service authorization workflows.
This position is administrative and healthcare operations focused, but it does include communication with providers, members, care teams, and internal staff. It is best suited for candidates with administrative support, prior authorization, utilization management, medical terminology, managed care, insurance, documentation review, or healthcare customer support experience.
### Key Responsibilities
* Process and enter authorization requests accurately and efficiently
* Review care team service requests and validate required documentation
* Follow up with care teams for missing or additional information
* Maintain detailed records of authorization approvals, denials, and modifications
* Collaborate with UM nurses and care teams to escalate requests needing clinical review
* Monitor authorization timelines and turnaround times to prevent delays
* Communicate with providers, members, and internal teams regarding service approvals
* Identify discrepancies, errors, or workflow inefficiencies and help resolve them
* Support training and onboarding of new team members as needed
* Follow utilization management policies, procedures, and quality standards
### Requirements
* 1+ year of administrative or technical support experience
* Excellent verbal and written communication skills
* Working knowledge of Microsoft Office, including Word, Excel, and Outlook
* Ability to quickly learn new systems
* High-speed DSL or cable internet for home office; satellite internet not allowed
* Strong attention to detail and documentation accuracy
* Ability to work independently with minimal direction
* Passion for improving consumer experiences
### Preferred Qualifications
* Experience using electronic medical record or documentation systems
* Medical terminology and/or ICD-10 coding knowledge
* Bachelor’s degree in Business, Finance, or related field
* Prior member service or customer service telephone experience
* Experience with utilization review or prior authorization
* Managed care organization experience preferred
### Benefits
* Medical, dental, and vision benefits
* 401(k) retirement savings plan
* Paid time off
* Company and personal holidays
* Volunteer time off
* Paid parental and caregiver leave
* Short-term and long-term disability
* Life insurance
* Additional wellness and whole-person well-being benefits
### Good Fit For
This role may be a strong fit for candidates with experience in prior authorization, utilization management, healthcare administration, insurance verification, managed care, medical records, documentation review, administrative support, customer support, claims support, care coordination support, or back-office healthcare operations.