Platform Summits: Referrals Jam
CoinbaseFull Time
Junior (1 to 2 years)
Candidates must possess a High School Diploma or equivalent, with an Associate's degree preferred. A minimum of 1 year of customer service or healthcare-related experience is required, preferably in a home health environment. Experience with healthcare insurance verification and a working knowledge of Medicare enrollment and home health agency guidelines are preferred. The ability to type 40 WPM, comprehend basic math for data analysis, and demonstrate strong logical thinking, decision-making, customer service, and communication skills are essential. Candidates must also possess strong attention to detail, time management skills, adaptability, and the ability to work under pressure and adhere to strict timelines. Fluency in English (reading, writing, speaking) and good attendance are mandatory. Reliable internet service with at least 25 Mbps download and 10 Mbps upload speeds is also required.
The E-Referral Specialist is responsible for monitoring multiple e-referral systems to identify new referrals, managing alerts, and continuously monitoring email for referral requests. This role involves performing timely follow-ups, managing related communication, and scanning documentation to determine patient eligibility for services. The specialist will assist with authorizations, monitor referral statuses, and report on them weekly. They will communicate with branch, sales, and leadership regarding status updates and referral decisions, and maintain the ERST log with all referral and ROC decisions. Maintaining productivity levels, complying with regulatory compliance areas, policies, and procedures, and adhering to company best practices are also key responsibilities. The role may also involve performing other related duties as assigned.
Health insurance provider for seniors and military
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.