Referral Specialist I (contract) Details

Referral Specialist I (contract)

Anthem - Deerfield, IL

Employment Type : Full-Time

Your Talent. Our Vision. At Anthem, Inc., 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 as a contractor at Anthem (via BC Forward) that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

This is a fast pace customer service call center where Referral Specialists are expected to completed up 80 calls per day. 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.

Requirements:

• Requires 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.
• Experience with medical terminology - diagnosis, symptoms, procedures etc.
• Computer proficiency - ability to set up w@h station with printed instructions
• Experience working with dual monitors and multiple tab applications
• Minimum 1 year customer service experience
• Ability to be flexible to be assigned shift between the hours of 7 am - 6 pm CST.

Additional Details:

• Required to Hard wire Ethernet cord to Internet provider modem - (Anthem will provide equipment)
• Possible Temp To Hire

An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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