Referral Specialist I
Company: Anthem, Inc
Location: Rancho Cordova
Posted on: January 11, 2022
SHIFT: Day Job
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 Specialists responsible for providing support to a
clinical team in order to facilitate the administrative components
of clinical referrals for various AIM services. AIM Specialty
Health is a wholly-owned subsidiary of Anthem focused on specialty
Location: This is a 100% remote position from day one forward.
Successful candidates will meet Anthem Work at Home requirements
including hard-wired high speed internet and a private secure
Hours: Successful candidates must be available to work any 8.5 hour
shift between 8:30 M and 6:30 PM CST (Central Standard.) Your shift
will be scheduled for 8.5 hours with two paid 15 minute breaks at
set times and 30 minute unpaid break at a set time, resulting in 8
hours of work time daily.
This team supports a back-pain management program and will
primarily be engaging with members during outbound calls. During
these calls, you will be providing the members with information
about that program and the unique opportunities we offer, then
connecting the members with the clinical team. Additional duties
may include, but are not limited to:
+ Initiates and manages clinical referrals for
+ 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
The health of our associates and communities is a top priority for
Anthem. We require all new candidates to become vaccinated against
Covid-19. All offers of employment are conditioned on completion of
a background check, including COVID-19 vaccination verification. 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.
+ HS diploma or GED; and
+ Minimum of 1 year of experience in a high-volume, interactive
customer service or call center environment;
+ Or any combination of education and experience which would
provide an equivalent background.
+ Knowledge of medical terminology
+ Healthcare experience
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.
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.
Anthem is an Equal Employment Opportunity employer and all
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, age, national origin,
protected veteran status, disability status, sexual orientation,
gender identity or expression, marital status, genetic information,
or any other characteristic protected by law. Applicants who
require accommodation to participate in the job application process
may contact firstname.lastname@example.org for assistance.
Anthem promotes the delivery of services in a culturally competent
manner and considers cultural competency when evaluating applicants
for all Anthem positions.
Keywords: Anthem, Inc, Rancho Cordova , Referral Specialist I, Other , Rancho Cordova, California
Didn't find what you're looking for? Search again!