E-Referral Specialist Home Health

Full-time role: 40 hours per week.

Shift/

Schedule:

Monday-Friday from 9am-6pm EST. Occasional weekend coverage required.

Holidays: Must be available to work at least 2 holidays per year, with additional holiday coverage when needed based on business needs.

As an E-Referral Specialist you will report to the E-Referral Supervisor. You will be an important part of the referral process as this role is the initial contact point for the client or referral source to promote the continuity of care. You will be responsible for data collection and documentation, compliance, and follow up on the initial referral process and decision.

• Monitor multiple e-referral systems to identify new referrals and manage alerts and notifications.

• Monitor email for request to pull referrals from all applicable referral systems. Perform follow-up and manage all related communication.

• Scan documentation to determine patient eligibility for services (service area, orders, insurance, etc.)

• Monitor status of all referrals received, follow up with each throughout process, reports on status weekly.

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

• Daily management of ERST log with all referrals and ROCs decisions.

• Maintain acceptable productivity level, as determined by work assignment and departmental standards.

• Comply with and follow all regulatory compliance areas, policies & procedures, and company best practices.

• High School Diploma or its equivalent

• Can type 40 words per minute or more

• Comprehend and apply principles of basic math while analyzing data and generating reports

• Proficiency with Microsoft Office applications including Word, Excel, Outlook, and Teams

• Good logical thinking and decision-making skills

• Can follow strict timelines

• Communication with all levels of management

• Can work with multiple screens/systems ensuring accuracy to detail

• Time management skills and can work in a fast-paced environment

• Must read, write and speak fluent English

• Must have good and regular attendance

• Approximate percent of time required to travel: 0%

• Experience processing incoming referrals using eReferral portals and EPIC systems

• 1 or more years customer service or other healthcare related experience; preference working in a home health environment

• Knowledge of the issues related to the delivery of home health services

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

• Associates degree

Work at Home Requirements:
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Florida Background Screening Requirements:
Notice for candidates applying to this position from a Florida work location, including Florida home-based work location. This position is subject to Florida Level 2 background screening through the Care Provider Background Screening Clearinghouse. For information about the screening process and requirements,…