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.
Will handle requests from the provider side (doctors, primary care physicians, specialists, etc.)
Decisions are typically focused 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.
We are fortunate to offer a remote opportunity for this position.
Our Fortune 100 Company values associate engagement & your well-being.
We also provide excellent professional development & continued education.
Required Qualifications – What it takes to Succeed
Minimum of 2 years of customer service experience in healthcare or medical field.
Familiar with medical terminology and/or ICD-10 codes.
Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems.
Schedule will be 8:00-5:00 EST Tuesday – Saturday with voluntary overtime, pending business needs.
Training: Monday – Friday approximately 7-8 weeks (5 weeks technical training, 2-3 weeks shadowing) and then a transition to the Tuesday-Saturday schedule, once fully trained.
Bilingual in English/Spanish.
Proficient utilizing electronic medical record and documentation programs.
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours