Telephonic UM Administration Coordinator

36107 Montgomery, Alabama Humana

Posted today

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Job Description

**Become a part of our caring community and help us put health first**
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.
UM Administration Coordinator 2
+ Primarily receive calls from Providers, Hospitals, Skilled Nursing Facilities and other vendors
+ Support the UM Nurses to process discharge orders and arrange a safe facility discharge.
+ Work with UM Nurses, Pharmacy, Medical Directors and other Departments.
+ During downtime make calls to UM Nurses, Hospitals, Skilled Nursing Facilities and other vendors.
+ Document all calls and requests.
+ Search for Medicare and Medicaid Guidelines.
+ Process all incoming fax/emails request for services the same day.
+ Return call for all voice messages received the same day.
+ Process provider and member letters (Letter of Agreements, Approvals, Denials etc.)
+ Mail letters to members.
+ Assist the team with various clerical/administrative tasks as necessary.
+ Participate in special projects as assigned by your Supervisor or Manager.
**Use your skills to make an impact**
Additional Job Description
**Required Qualifications**
+ 1 or more years of Administrative support experience
+ 1 or more years of Healthcare experience
+ 1 or more years of telephonic Customer Service experience
+ Working knowledge of Microsoft Word, Excel, and Outlook.
+ Monday-Friday 8am-5pm EST, must have ability to work Nights, Weekends and Holidays based on business needs.
**Preferred Qualifications**
+ Bilingual English/Spanish able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing
+ Proficient utilizing documentation programs.
+ Experience with the CarePlus Platform.
+ Proficient and/or experience with medical terminology and/or ICD-10 codes.
+ Member service
+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
**Additional Information**
**Work Schedule:**
+ Monday-Friday 8am-5pm EST, and work 1 weekend a quarter. Schedule subject to change based on business needs.
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, 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.
**Work at Home Guidance**
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
#LI-BB1
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**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
**Description 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About us**
About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties.
About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large.

**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 complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
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Utilization Management Administration Coordinator (SNF)

36107 Montgomery, Alabama Humana

Posted today

Job Viewed

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Job Description

**Become a part of our caring community and help us put health first**
The UM Administration Coordinator 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.
Job Description
**Achieve your best at Humana. Join Us!** The UM Administration Coordinator provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.
The Home Solutions UM Team is hiring for a UM Administration Coordinator that will provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and contributes to the Value-Based segment partnering with CenterWell and Onehome.
+ Manages NLP's for chart reviews for the nursing team
+ Builds and pends 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
+ Documents calls and attaches clinical information received
+ Requests clinical information from providers/facilities
+ Creates and sends out written correspondence
+ Creates and distributes determination letters
+ Collaborates with multiple roles/departments/providers/team members
*** REMINDER: ATTACH A COPY OF YOUR RESUME***
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
+ Medical Benefits
+ Dental Benefits
+ Vision Benefits
+ Health Savings Accounts
+ Flex Spending Accounts
+ Life Insurance
+ 401(k)
+ PTO including 8 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
+ And more
**Use your skills to make an impact**
**Required Qualifications**
+ 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
**Additional Information**
+ **Remote position with possibility of flexible working hours Monday to Friday between 8am and 8pm EST (8 paid hours per business day)**
+ **Overtime available based upon business needs**
+ **Weekend and/or holiday work possible for this role**
Work at Home/Remote Requirements
**Work-At-Home Requirements**
+ To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
+ Wireless, Wired Cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
+ Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
**Our Hiring Process**
As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
#LI-LM1
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**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
**Description 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

**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 complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
View Now

Data Analyst - Entry

36136 Montgomery, Alabama SynergisticIT

Posted 24 days ago

Job Viewed

Tap Again To Close

Job Description

re you passionate about coding or technology and ready to make your mark in tech? For more than 14 years , SynergisticIT has been helping aspiring developers like you excel in the tech industry. We focus on equipping you with the skills and experience needed to not only secure a job but to thrive in your career!
Why Partner with SynergisticIT?

  • Customized inputs to achieve the desired output : designed with industry needs in mind, ensuring you're equipped with the most sought-after skills.
  • Exclusive Opportunities: Our extensive network allows you to connect with leading tech firms.
  • Outstanding Outcomes: Many of our candidates land multiple job offers, often with starting salaries of $100k or more!

Synergisticit Pics /Salaries of Successful Candidates

Synergisticit at Oracle Cloudworld 2023

Synergisticit at Gartner Data & Analytics summit

Why do Tech Companies not Hire recent Computer Science Graduates | SynergisticIT

Technical Skills or Experience? | Which one is important to get a Job? | SynergisticIT

Who Should Apply? We're looking for recent grads in Mathematics, Statistics , Computer Science or Engineering or candidates with gaps in their career or people wanting to switch careers into tech. SynergisticIT is committed to supporting your journey!
Preferred SKILLS For Java /Full stack/Devops Positions
ssociate or Bachelors degree or Masters degree in Computer Science, Computer Engineering, Electrical Engineering, Information Systems, IT
Knowledge of Core Java , javascript , C++ or software programming
Spring boot, Microservices, Docker, Jenkins, Github, Kubernates and REST API's experience
For data Science/Data Analyst/AI/Machine learning Positions
Preferred SKILLS
ssociate or Bachelors degree or Masters degree in Computer Science, Computer Engineering, Electrical Engineering, Information Systems, IT, Statistics, Mathematics or having good logical aptitude
Knowledge of Statistics, Gen AI, LLM, Sagemaker, Python, Computer Vision, data visualization tools
Candidates lacking technical skills or relevant experience can research our Job Placement Programs which can assist in landing a Job
If you get emails from our Job Placement team and are not interested please email them or ask them to take you off their distribution list and make you unavailable as they share the same database with the client servicing team who only connect with candidates who are matching client requirements.
No phone calls please. Shortlisted candidates would be reached out. No third party or agency candidates or c2c candidates

Embrace Your Future! We also assist with F1 OPT to transition into H1B and Green Card byproviding comprehensive support. All positions are open to candidates of all visa types and US citizens.
re you ready to make an impact?
View Now

Remote Data Entry Research Panelist Work From Home

36101 Montgomery, Alabama Maxion Corp LLC

Posted 13 days ago

Job Viewed

Tap Again To Close

Job Description

Job Description
Join Our Team as a Work-From-Home Data Entry Research Panelist!

Are you ready to earn money from the comfort of your own home? This exciting opportunity is perfect for anyone with a variety of skills and backgrounds - whether you've been an administrative assistant, data entry clerk, typist, customer service rep, or even a driver!

Why You'll Love This Job:
  • Flexibility at Its Best: Work part-time or full-time, from anywhere, and on a schedule that fits your life.
  • No Experience? No Problem! Comprehensive training is provided to set you up for success.
  • Variety of Opportunities: Choose from a range of career fields and find the perfect fit for your talents.
What You'll Do:
  • Participate in research studies that contribute to meaningful outcomes.
  • Enjoy the freedom of remote work while building your career.

This role is your chance to turn your skills into income while working in an environment that's convenient and accommodating. Don't wait - take the first step toward a rewarding work-from-home career today!

Apply now and start building the flexible, fulfilling future you deserve.

Requirements
  • Computer with internet access
  • Quiet work space away from distractions
  • Must be able and comfortable to working in an environment without immediate supervision
  • Ability to read, understand, and follow oral and written instructions.
  • Data entry or administrative assistant experience is not needed but can be a bonus
  • We are recruiting those who have a background in health care, warehouse worker, delivery drivers, customer service, etc - we welcome all backgrounds so long as you're ready to learn

To get started, these are the essential elements you'll need!

  • LapTop. You may be asked to use your webcam. These types of studies typically pay more. You'll need a stable internet connection. You may be asked to conduct a study using your SmartPhone.
  • Data entry skills. All studies require that you be able to read, write and take direction as well as type a minimum of 25 words per minute.

Benefits
  • Work when you want
  • Earn cash working part time or full time.
  • Learn new skills that you can take anywhere.
  • No degree required
  • Supplement your existing job. No need to quit your current job, unless you really hate it.
  • Excellent job for Stay at home moms, retired folks, disabled people and anyone looking to learn how to make income online.
View Now

Remote Data Entry Work From Home Focus Group Panelist

36066 Prattville, Alabama Maxion Corp LLC

Posted today

Job Viewed

Tap Again To Close

Job Description

Job Description
Join Our Team as a Work-From-Home Data Entry Research Panelist!

Are you ready to earn money from the comfort of your own home? This exciting opportunity is perfect for anyone with a variety of skills and backgrounds - whether you've been an administrative assistant, data entry clerk, typist, customer service rep, or even a driver!

Why You'll Love This Job:
  • Flexibility at Its Best: Work part-time or full-time, from anywhere, and on a schedule that fits your life.
  • No Experience? No Problem! Comprehensive training is provided to set you up for success.
  • Variety of Opportunities: Choose from a range of career fields and find the perfect fit for your talents.
What You'll Do:
  • Participate in research studies that contribute to meaningful outcomes.
  • Enjoy the freedom of remote work while building your career.

This role is your chance to turn your skills into income while working in an environment that's convenient and accommodating. Don't wait - take the first step toward a rewarding work-from-home career today!

Apply now and start building the flexible, fulfilling future you deserve.

Requirements
  • Computer with internet access
  • Quiet work space away from distractions
  • Must be able and comfortable to working in an environment without immediate supervision
  • Ability to read, understand, and follow oral and written instructions.
  • Data entry or administrative assistant experience is not needed but can be a bonus
  • We are recruiting those who have a background in health care, warehouse worker, delivery drivers, customer service, etc - we welcome all backgrounds so long as you're ready to learn

To get started, these are the essential elements you'll need!

  • LapTop. You may be asked to use your webcam. These types of studies typically pay more. You'll need a stable internet connection. You may be asked to conduct a study using your SmartPhone.
  • Data entry skills. All studies require that you be able to read, write and take direction as well as type a minimum of 25 words per minute.

Benefits
  • Work when you want
  • Earn cash working part time or full time.
  • Learn new skills that you can take anywhere.
  • No degree required
  • Supplement your existing job. No need to quit your current job, unless you really hate it.
  • Excellent job for Stay at home moms, retired folks, disabled people and anyone looking to learn how to make income online.
View Now

Junior/Entry Data Analyst

36136 Montgomery, Alabama SynergisticIT

Posted 24 days ago

Job Viewed

Tap Again To Close

Job Description

Are you passionate about coding or technology and ready to make your mark in tech? For more than 14 years , SynergisticIT has been helping aspiring developers like you excel in the tech industry. We focus on equipping you with the skills and experience needed to not only secure a job but to thrive in your career!
Why Partner with SynergisticIT?

  • Customized inputs to achieve the desired output : designed with industry needs in mind, ensuring you're equipped with the most sought-after skills.
  • Exclusive Opportunities: Our extensive network allows you to connect with leading tech firms.
  • Outstanding Outcomes: Many of our candidates land multiple job offers, often with starting salaries of $100k or more!


Why do Tech Companies not Hire recent Computer Science Graduates | SynergisticIT
Technical Skills or Experience? | Which one is important to get a Job? | SynergisticIT
How Can Recently Laid Off Tech People Get Employed Again? | SynergisticIT

Who Should Apply? We're looking for recent grads in Mathematics, Statistics , Computer Science or Engineering or candidates with gaps in their career or people wanting to switch careers into tech. SynergisticIT is committed to supporting your journey!
Preferred SKILLS For Java /Full stack/Devops Positions
Associate or Bachelors degree or Masters degree in Computer Science, Computer Engineering, Electrical Engineering, Information Systems, IT
Knowledge of Core Java , javascript , C++ or software programming
Spring boot, Microservices, Docker, Jenkins, Github, Kubernates and REST API's experience
For data Science/Data Analyst/AI/Machine learning Positions
Preferred SKILLS
Associate or Bachelors degree or Masters degree in Computer Science, Computer Engineering, Electrical Engineering, Information Systems, IT, Statistics, Mathematics or having good logical aptitude
Knowledge of Statistics, Gen AI, LLM, Sagemaker, Python, Computer Vision, data visualization tools
Candidates lacking technical skills can research our Job Placement Programs which can assist in landing a Job
If you get emails from our Job Placement team and are not interested please email them or ask them to take you off their distribution list and make you unavailable as they share the same database with the client servicing team who only connect with candidates who are matching client requirements.
No phone calls please. Shortlisted candidates would be reached out. No third party or agency candidates or c2c candidates

Embrace Your Future! We also assist with F1 OPT to transition into H1B and Green Card byproviding comprehensive support. All positions are open to candidates of all visa types and US citizens.
Are you ready to make an impact?
View Now
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