This will be a hybrid role - working some days at home and others in the office (could be at least 1 day a week), located at 101 E. Main Street, Louisville, KY. This will require candidates that live within a commutable distance to the in office location.
The UM Administration Coordinator 2 will report to a Supervisor of Appeals Nursing. You will perform in a support role providing clerical fulfillment for medical management teams.
You will review, scan, and reroute in-office physical mail related to appeals and other denial correspondence
You will review and distribute returned mail for research
You will review claim denial codes eligible for appeal, and identify denial correspondence to be directed to other departments
You will also process emails and faxes related to appeals and correspondence, and send out non covered benefit letters.
Required Qualifications
Our Department of Defense contract requires U.S. Citizenship
Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)
HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.
Live within a commutable distance to the Clocktower Building, at 101 E. Main Street, Louisville KY
1 year of administrative and technical support experience
Must be able to sit or stand in a stationary position for up to 8 hours
Must be able to lift up to 30 lbs
Experience with medical terminology and/or ICD-10 codes
Preferred Qualifications
Prior experience working in a Mailroom setting
Prior experience working in a managed care organization to include TRICARE
Experience with Utilization Review and/or Prior Authorization
Experience in claims
Experience with electronic medical record and documentation programs
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$40,000 - $52,300 per year
of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana will never ask, nor require a candidate to provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact yourcareer@humana.com to validate the request
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
