Become a part of our caring community and help us put health first
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
Healthcare insurance verification experience preferred
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 preferred
Working knowledge of Medicare enrollment and guidelines governing home health agencies preferred
Demonstrate 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%
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.
CenterWell Home Health offers a variety of benefits to promote the best health and well-being of our employees and their families. Our competitive and flexible benefits surround you with support the same way you do for our patients and members, including:
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
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.
$39,000 - $49,400 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 CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
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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.
Centerwell, a wholly owned subsidiary of 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 full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources
