Location: Irving , TX, United States
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. Responsibilities 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. Humana is seeking a Prior Authorizations Specialist to create prior authorizations online requested from physician offices and pharmacies. + Creation of prior authorizations following companys processes from online sources + Use of attention to detail to provide accurate data entry and timely resolutions for authorization requests + Build lasting relationships with Humanas customers via outbound calls when needed: Physician offices, pharmacies, and members Required Qualifications + High School Diploma or equivalent + Intermediate proficiency in all Microsoft Office Programs, including Word, PowerPoint, Excel, and Access + Ability to type 50-55 wpm + Capacity to maintain confidentiality + Department Hours: 8:00 AM 6:30 PM Monday through Friday. Overtime and weekends as needed. Must have flexibility in your schedule, including weekends and overtime as business needs arise + Experience as a Pharmacy Technician or equivalent in retail, mail order, or hospital relating to brand/generic medication, reading sig codes, and calculating quantity is strongly preferred + Attention to detail is essential + Preferred Qualifications + Pharmacy Technician Certification + Experience in medical field and ICD 10 codes + Associates or Bachelors Degree + Previous inbound call center or related customer service experience + Prior Authorization Experience + Fluency in Spanish Additional Information Scheduled Weekly Hours 40 About Us Mission: 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 thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact email@example.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate 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 firstname.lastname@example.org to validate the request.