Job Information

Humana E-Referral Specialist PRN in Charlotte, North Carolina

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.

Required Experience/Skills:

  • High School Diploma or its equivalent; Associates degree preferred

  • Healthcare insurance verification experience required

  • Minimum 1 year customer service or other healthcare related experience; preference working in a home health environment

  • Good knowledge of the issues related to the delivery of home health services

  • Working knowledge of Medicare enrollment and guidelines governing home health agencies

  • Demonstrated ability to type 40 wpm

  • Ability to comprehend and apply principles of basic math while analyzing data and generating reports

  • Good logical thinking and decision making skills

  • Able to work well under pressure and adhere to strict timelines

  • Possess excellent customer service skills; ability to communicate professionally and effectively with all levels of management

  • Strong attention to detail with ability to multi-task and work with multiple screens/systems.

  • Good time management skills and are able to work in a fast-paced environment

  • Strong adaptability to change

  • Must read, write and speak fluent English

  • Must have good and regular attendance

  • Approximate percent of time required to travel: 0%

  • This role requires full COVID-19 vaccination.

Required Skills

Together, we can raise the bar on home healthcare

CenterWell™ Home Health (formerly Kindred at Home), is one of the nation’s leading providers of home care, with an incredible team of compassionate clinicians who deliver high-quality, specialty care to patients. Many of our clinicians live in the same neighborhoods they serve – providing the much-needed care to people in their community.

As a company, we strive to lead by example and show employees the same compassion and care we expect them to show patients. We provide employees the resources, stability, and job flexibility they truly deserve. We help them fulfill their personal and professional goals while enjoying industry-leading benefits, competitive salaries, opportunities for career and professional growth, and a healthy work/life balance.

Part of Humana’s Home Solution business

CenterWell Home Health cares for nearly 80,000 patients every day in over 350 locations, across 38 states. As part of Humana Inc., we create experiences that put patients at the center, working in collaboration with healthcare providers to bring multidisciplinary care directly to the comfort and safety of home. The result is easy, comprehensive and personalized care that helps patients lead healthier, happier lives.

Caring for people who care for our patients

Experience has shown us that supporting and nurturing employees helps them become the best version of themselves and more compassionate, committed home health professionals. That’s why CenterWell Home Health never stops working to improve the employee experience. Our people are our greatest resource, and we are committed to creating an environment they enjoy stepping into every day.

World-class employee benefits

  • Competitive pay and benefits package

  • 50% matching 401(k) contributions up to 6%

  • Career advancement opportunities

  • Tuition reimbursement program

  • Advanced Continuing Education (CE) accredited training

Required Experience

Job Category: Administrative and Clerical

ID: 167613