E-Referral Specialist Home Health

Summary: Humana is a leading healthcare services company focused on creating integrated and personalized experiences for patients. The E-Referral Specialist role involves managing the referral process, ensuring compliance, 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 for request to pull referrals from all applicable referral systems. Perform follow-up and manage all related communication - Scan documentation to determine patient eligibility for services (service area, orders, insurance, etc.) - Help with authorizations - Monitor status of all referrals received, follow up with each throughout process, reports on status weekly - Communicate with branch, sales, leadership by email or phone for status updates and referral decisions - Daily management of ERST log with all referrals and ROCs decisions - Maintain acceptable productivity level, as determined by work assignment and departmental standards - Comply with and follow all regulatory compliance areas, policies & procedures, and company best practices Required Qualifications: - High School Diploma or its equivalent - Can type a minimum of 40 wpm - Comprehend and apply principles of basic math while analyzing data and generating reports - Good logical thinking and decision-making skills - Can follow strict timelines - Communication with all levels of management - Can work with multiple screens/systems ensuring attention to detail - Time management skills and can work in a fast-paced environment - Must read, write and speak fluent English - Must have good and regular attendance - Approximate percent of time required to travel: 0% Preferred Qualifications: - Patient referral and insurance verification experience - Minimum 1 year customer service or other healthcare related experience; preference working in a home health environment - Knowledge of the issues related to the delivery of home health services - Working knowledge of Medicare enrollment and guidelines governing home health agencies - Associates degree Required Skills: Typing (40 wpm), Basic math, Patient referral, Insurance verification, Medicare enrollment knowledge, Home health services knowledge, Logical thinking, English language proficiency, Decision making Benefits: Medical, Dental and vision benefits, 401(k) retirement savings plan, Paid time off, Company and personal holidays, Volunteer time off, Paid parental and caregiver leave, Short-term and long-term disability, Life insurance