Anthem, Inc. AIM Specialty Health-Referral Specialist I- Westchester in Westchester, Illinois
SHIFT: Day Job
Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies, 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.
Due to the current COVID-19 (coronavirus) pandemic, this position will require you to work remotely from your home with the flexibility to return to a regular, in-office work environment. As we continue to monitor guidance from CDC and state officials there may be times you would need to report to the office on a monthly or quarterly basis for team meetings or engagement activities.
The Referral Specialist will be responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals for various AIM services.
$17.61 per hour with a Quarterly Incentive Plan
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.
High School diploma or GED; 1-3 years of experience in a high-volume, interactive customer service or call center environment; working knowledge of medical terminology; or any combination of education and experience which would provide an equivalent background.
Experience using Microsoft Office Suite including Outlook, Word & Excel preferred
Ability to work any eight-hour shift between the hours of 7:00 am-6:00 pm CT, Monday through Friday. During the first six weeks, schedules will vary.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.