[Remote] E-Referral Specialist Home Health

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