Referral Coordinator
Humana

North Miami Beach, Florida

Posted in Insurance
5 days ago


Job Info


Description

Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole.

Responsibilities

Conviva is seeking a candidate to join our Team as a Referral Coordinator who has experience working in a medical office and with managed care. Candidate must be Bilingual in English and Spanish, must be organized with excellent time management, communication, and computer skills. Candidate must have experience/knowledge of the referral process, be detail oriented, have the ability to multi-task, be able to process/complete referrals in a timely manner, and be passionate about contributing to an organization focused on continuously improving consumer experiences. If you possess these skills and are interested, we look forward to speaking with you.

The Referral Coordinator mediates between patients, insurance companies, and medical care providers, keeping track of records and making sure all patient information is correct. Typically works on routine and patterned assignments. Works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation. Decisions are limited to defined parameters around work expectations, quality standards, priorities, and timing.

Center Address: Conviva North Miami Beach: 1648 NE 163rd Street, North Miami Beach, FL 33162

Job Functions

  • Coordinate referral appointments.
  • Verify patient insurance information.
  • Gather and communicate all relative information and preparation instructions to patient and referring providers.
  • Schedule and pre-register patients for exams/procedures with specialists/providers outside of the primary care physician's office.
  • Arrange transportation to outside appointments.
  • Obtain referral authorizations via Health Portal.
  • Maintain and update patient records.
  • Scan and upload referral documentation into EMR system.
  • Balance administrative and patient service tasks to support quality care.
  • Provide outstanding customer service.
Required Qualifications
  • Must be Bilingual English (read, write & speak) and Spanish (speak).
  • Must have working experience and knowledge of Referral Process.
  • Proficient with Microsoft Office applications including Microsoft Word, Excel and Outlook.
  • Knowledge of ICD 10 and CPT coding.
  • Proficient with medical terminology.
  • Experience with Electronic Medical Records (EMR) system.
  • Excellent written and verbalcommunication skills.
  • This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Preferred Qualifications
  • High School Diploma or GED
Working Hours: Monday - Friday from 8:00am to 5:00pm

Alert

Conviva, a subsidiary of Humana, values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will receive a set of interview questions over your phone and you will provide recorded or text message responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

Benefits

Being a part of the Conviva team gives you: We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k, tuition reimbursement, vacation, paid holidays, work-life balance, growth, a positive and fun culture and much more.

Scheduled Weekly Hours

40



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