E-Referral Specialist Home Health

CenterWell

1d • Remote

About The Position

Become a part of our caring community. As an E-Referral Specialist, you will report to the E-Referral Supervisor. You will be an important 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. You will be responsible for data collection and documentation, compliance, and follow up on the initial referral process and decision. 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. CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM).

Requirements

• 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
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required for self-provided internet service (for Home or Hybrid Home/Office employees); wireless, wired cable or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• 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

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.

Benefits

• Medical benefits
• Dental benefits
• 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 disability
• Long-term disability
• Life insurance
• Bi-weekly payment for internet expense for employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota
• Telephone equipment appropriate to meet the business requirements for their position/job

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED