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Referral Services Assistant

Full-Time

Mid Level

Remote

$29.000 - $3.800

22 Sep → 22 Oct

Anthem

Miami, FL, USA

About Company

Your Talent. Our Vision. At Simply Healthcare, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. We are a Florida licensed health maintenance organization that serves individuals enrolled in Medicaid and/or Medicare programs, Join us and together we will drive the future of health care.
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Job Description

The Referral Services Assistant is responsible for providing support to clinical team to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional counseling, etc.

Job Responsibilities

  • Initiates and manages clinical referrals for participants registered in a disease management or health program.
  • Acts as a liaison between hospital, health plans, physicians, patients, vendors, and other referral sources.
  • Reviews referrals for completeness and follows up for additional information.
  • Assigns referrals to staff.
  • Verifies insurance coverage and obtains authorizations from insurance plans.
  • Maintains database of insurance companies for verification of coverage, accepted plans, and requirements for patient eligibility.
  • Contacts physician offices to obtain demographic information or related data.
  • Enters referrals and documents communications in system.

Requirements / Qualifications

  • Requires a HS diploma and a minimum of 1 year of experience in a healthcare environment
  • Or any combination of education and experience which would provide an equivalent background
  • Ability to travel may be required.

Benefits/What We offer

  • Market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

How To Apply

Apply through GoRemotely. 

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