Anthem, Inc. Referral Specialist I in San Jose, California
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.
This position is responsible for providing support to a clinical team to facilitate the administrative components of clinical referrals for various AIM services.
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.
Here’s what Anthem offers:
A career path with opportunity for growth.
Work remote 100%.
Ability to obtain your Associate’s or bachelor’s degree paid for in full or further your education with tuition reimbursement.
Affordable Health Insurance, Dental, Vision and Basic Life.
401K match, Paid Time Off, Holiday Pay.
Quarterly incentive bonus and annual increases plan based on performance.
High School diploma or GED equivalent from an accredited institution.
1-3 years of experience in a high-volume, interactive customer service or call center environment within the healthcare industry.
Can manage a large volume of inbound calls and has a proven track record in a fast paced, multitasking environment.
Strong written and verbal communication skills.
Technically proficient in the use of MS Office Suite, and ability to learn new software.
Strong decision making and problem-solving skills.
Detail oriented and exceptional time management skills.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.