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AIM Specialty Health Referral Services Assistant - RSA - Westchester, IL - PS14450

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Customer Service
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PS14450 Requisition #
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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.

 

Referral Services Assistant -

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

 

Primary duties may include, but are not limited to

  • 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:

  • High school diploma or GED
  • Minimum of one year experience in a healthcare environment or graduate/recent graduate of a health care curriculum education or any combination of education and experience, which would provide an equivalent background.
  • Minimum one year customer service and/or call center experience
  • Solid typing skills and familiarity with word processing software
  • Demonstrated ability to operate independently as well as part of a team and to follow directives
  • Flexibility to work an 8 hour shift between the hours of 12:00pm and 8:30pm local time.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc 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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Enable physicians and hospitals to improve care with valuable information that improves care quality and affordability. Join us and help provide tools to help consumers make better decisions, as we create a simpler, more affordable, more accesible healthcare system.

Metrics and data associates at Anthem:

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