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AIM Specialty Health Referral Specialist I - Glendale, CA - PS17779

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Customer Service
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PS17779 Requisition #
Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies,  it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve. 
 
The Referral Specialist will be responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals for various AIM services. 

Primary duties may include, but are not limited to: 

  • Initiates and manages clinical referrals for pre-authorization. 
  • 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 if necessary. 
  • Assigns escalated referrals to staff as appropriate. 
  • Verifies insurance coverage and completes pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures. 
  • Responds to inbound calls initiating exam requests following established processes, meets quality and production standards. 
  • Contacts physician offices as needed to obtain demographic information or related data. 
  • Enters referrals, documents communications and actions in system. 
High School diploma or GED
  • 1-3 years of experience in a high-volume, interactive customer service or call center environment, with working knowledge of medical terminology or any combination of education and experience, which would provide an equivalent background.
  • Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 Diversity Inc. magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

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    Medical

    Drive the future of health care, by helping to improve health outcomes and consumers' quality of life.

    Build upon your clinical skills and experience opportunities for advancement while enjoying a more balanced way of life. Join us and help improve health outcomes and consumers' quality of life.

    Medical associates at Anthem:

    • Work collaboratively within our team of exceptional nurses, physicians and pharmacists
    • Support the company's various business units in the development of innovative benefit designs that promote transparency, stability and affordability
    • Show initiative and make key decisions with the potential to influence patient outcomes and positively impact peoples' lives
    • Communicate effectively with associates at all levels of the company, fostering teamwork, while promoting corporate financial viability, stability and leadership
    • Ensure members get the support they need before, during and after their medical procedures, while helping to maintain exceptional quality control at every stage of the consumer journey

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