E-Referral Specialist, Home Health

This is a fully remote position, open to applicants in United States.

📋 Description

• Report directly to the E-Referral Supervisor.

• Oversee various e-referral systems to detect new referrals and manage alerts and notifications.

• Review email requests to extract referrals from relevant referral systems.

• Conduct follow-ups and handle associated communications.

• Examine documentation to assess patient eligibility for services, including service area, orders, and insurance coverage.

• Track the status of all referrals and ensure follow-up throughout the process.

• Provide weekly updates on referral status.

• Communicate with branch, sales, and leadership via email or phone regarding status updates and referral decisions.

• Maintain the ERST log daily with all referrals and ROCs decisions.

• Achieve acceptable productivity levels in accordance with work assignments and departmental standards.

• Adhere to regulatory compliance areas, policies and procedures, and company best practices.

• Act as the primary contact for clients or referral sources to ensure continuity of care.

• Gather and document referral information, manage compliance, and follow up on initial referral processes and decisions.

⛳️ Requirements

• High School Diploma or its equivalent is required.

• Ability to type 40 words per minute or more.

• Capable of understanding and applying basic mathematical principles while analyzing data and generating reports.

• Proficient in Microsoft Office applications, including Word, Excel, Outlook, and Teams.

• Strong logical thinking and decision-making abilities.

• Ability to adhere to strict timelines.

• Effective communication skills with all levels of management.

• Competent in working with multiple screens/systems while ensuring attention to detail.

• Strong time management skills and ability to thrive in a fast-paced environment.

• Must read, write, and speak fluent English.

• Consistent and reliable attendance is required.

• Availability to work 40 hours per week, Monday through Friday from 9 AM to 6 PM EST.

• Occasional weekend coverage may be necessary.

• Must be available to work at least 2 holidays per year, with additional holiday coverage as needed.

• Home internet connection with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• A dedicated workspace free from interruptions to safeguard member PHI/HIPAA information.

• Occasional travel to Humana offices for training or meetings may be required.

• Florida Level 2 background screening through the Care Provider Background Screening Clearinghouse is mandatory for candidates applying from a Florida work location.

• Preferred: Experience in processing incoming referrals using eReferral portals and EPIC systems.

• Preferred: One or more years of customer service or related healthcare experience.

• Preferred: Experience within a home health environment.

• Preferred: Knowledge of issues related to the delivery of home health services.

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

• Preferred: Associate's degree.

🏝️ Benefits

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Remote work opportunities.

• Flexible work arrangements for home-based employees.

• Global whole-person wellness and healthcare support.