Become a part of our caring community and help us put health first
 

This is a full time position scheduled for 40 hours/week. 

Shift/Availability requirements:

Option #1:

• Monday-Friday from 8:30am-5pm ET.

• Available to work weekend shifts twice a month.

• Available to work 3 holidays a year.

Option #2:

• Monday-Friday from 9:30am-6pm ET.

• Available to work weekend shifts twice a month.

• Available to work 3 holidays a year.

The E-Referral Specialist is an integral part of the referral process as this role is the initial contact point for the client or referral source to promote the continuity of care.  The role is responsible for data collection and documentation, compliance, and consistent follow up on the initial referral process and decision.

Essential Functions: 

• 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.

Use your skills to make an impact
 

Required Experience/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

Preferred Experience/Skills:

• 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

Additional Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees 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.

• Home or Hybrid Home/Office employees will be provided 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.

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 be