E-Referral Specialist

Humana 🏥💙🤝

Salary range

$39,000–$49,400/year

Benefits

Job Description

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.

About Humana

CenterWell Home Health specializes in personalized, comprehensive home care, a Humana company focused on whole-person health.

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