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Referral Services Assistant - Remote

Location:
JobFamily: Customer Service
Req #: PS63203
Date Posted: Dec 29, 2021

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Description:

Description

SHIFT: Day Job

SCHEDULE: 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 that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Referral Services Assistants are responsible for providing support to our clinical teams to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional counseling, etc. As a part of the CareMore team, you will be engaged with ensuring that our Medicare members receive the best possible care from their health plan.

Location: This is a 100% remote position; successful candidates will be located within 120 miles of an Anthem location nationwide. Successful candidates will meet Anthem Work at Home requirements including hard-wired high speed internet and a private secure workspace.

Hours: 8am-5pm- PST (Pacific Standard)

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.

 

Qualifications

 

Required:

  • HS diploma
  • Minimum of 1 year of experience in a healthcare environment;
  • Or any combination of education and experience which would provide an equivalent background.

Preferred:

  • Experience working with Medicare/ knowledge of Medicare health plans

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.


Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes.  To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. 

Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.