CenterWell Home Health, a Humana company, is seeking a per diem E-Referral Specialist to serve as the initial contact point, promoting continuity of care for clients and referral sources. You will be responsible for data collection, documentation, compliance, and follow-up throughout the initial referral process.
What You'll Do
- Monitor multiple e-referral systems to identify new referrals and manage alerts.
- Continuously monitor email for requests to pull referrals from all applicable systems.
- Perform timely follow-up and manage all related communication.
- Quickly scan documentation to determine patient eligibility for services.
- Assist, as needed, with authorization submission to ensure timeliness.
- Monitor status of all referrals, follow up throughout the process, and report weekly.
- Communicate with branch, sales, and leadership via email and/or phone for updates.
- Daily manage and update ERST log with all referrals and ROCs decisions.
- Maintain an acceptable productivity level per departmental standards.
- Comply with all regulatory areas, policies, procedures, and best practices.
- Work per diem, Saturday and Sunday 8am-6pm EST.
What We're Looking For
- High School Diploma or its equivalent.
- Minimum 1 year customer service or other healthcare related experience.
- Demonstrated ability to type 40 wpm.
- Ability to comprehend and apply principles of basic math while analyzing data.
- Good logical thinking and decision making skills.
- Able to work well under pressure and adhere to strict timelines.
- Excellent customer service skills and professional communication with all levels.
- Strong attention to detail with ability to multi-task across multiple screens/systems.
- Good time management skills and ability to work in a fast-paced environment.
- Strong adaptability to change.
- Must read, write and speak fluent English.
- Must have good and regular attendance.
- Performs other related duties as assigned.
- Home internet: minimum download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable or DSL connection suggested.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA.
Nice to Have
- Associate's degree.
- Healthcare insurance verification experience.
- Preference working in a home health environment.
- Good knowledge of issues related to the delivery of home health services.
- Working knowledge of Medicare enrollment and guidelines governing home health agencies.
Benefits & Compensation
- Compensation: $39,000 - $49,400 per year.
- Health benefits effective day 1.
- Paid time off, holidays, and jury duty pay.
- Recognition pay.
- 401(k) retirement savings plan with employer match.
- Tuition assistance.
- Scholarships for eligible dependents.
- Caregiver leave.
- Employee charity matching program.
- Network Resource Groups (NRGs).
- Career development opportunities.
- For per diem associates: paid time off, 401(k) plan, employee assistance program, business travel and accident insurance.
- Bi-weekly internet expense payment for employees in California, Illinois, Montana, or South Dakota.
- Telephone equipment provided.
Work Mode
This is a fully remote position.
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.
