Note: The job is a remote job and is open to candidates in USA. Humana is a leading provider of healthcare services, and they are seeking an E-Referral Specialist to enhance the referral process. The role involves managing e-referral systems, ensuring timely follow-ups, and maintaining communication with various stakeholders to promote continuity of care.
Responsibilities
- Monitor multiple e-referral systems to identify new referrals and manage alerts and notifications
- Monitor email continuously for request to pull referrals from all applicable referral systems. Perform timely follow-up and manage all related communication
- Quickly scan documentation to determine patient eligibility for services (service area, orders, insurance, etc.)
- Assists, as needed, with authorizations to ensure all are submitted in a timely manner
- Monitors status of all referrals received, follow up with each throughout process, reports on status weekly
- Communicate with branch, sales, leadership via email and/or phone for status updates and referral decisions as required
- Daily manage and update ERST log with all referrals and ROCs decisions
- Maintain acceptable productivity level, as determined by work assignment and departmental standards
- Comply with and adhere to all regulatory compliance areas, policies and procedures and company best practices
Skills
- High School Diploma or its equivalent; Associates degree preferred
- Demonstrated ability to type 40 wpm
- Ability to comprehend and apply principles of basic math while analyzing data and generating reports
- Good logical thinking and decision-making skills
- Able to work well under pressure and adhere to strict timelines
- Possess excellent customer service skills; ability to communicate professionally and effectively with all levels of management
- Strong attention to detail with ability to multi-task and work with multiple screens/systems
- Good time management skills and are able to work in a fast-paced environment
- Strong adaptability to change
- Must read, write and speak fluent English
- Must have good and regular attendance
- Approximate percent of time required to travel: 0%
- Performs other related duties as assigned
- Patient referral and insurance verification experience
- Minimum 1 year customer service or other healthcare related experience; preference working in a home health environment
- Good knowledge of the issues related to the delivery of home health services
- Working knowledge of Medicare enrollment and guidelines governing home health agencies
Benefits
- 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
Company Overview
Company H1B Sponsorship
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