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WellPoint
Location: Westchester, IL 60154 Document ID: A9122-33GI Posted on: 2015-03-2603/26/2015 Job Type: RegularJob Schedule:Full-time
Minimum Education: Not Specified2015-04-25
Healthcare Customer Service-Referral Specialist
Healthcare Customer Service-Referral Specialist
DESCRIPTION/RESPONSIBILITIES:
The Referral Specialist is Responsible for providing support to a
clinical team in order to facilitate the administrative components of
clinical referrals for various AIM services. 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.
EOE.M/F/Disability/Veteran
REQUIRED SKILLS:
Requires High School diploma or GED; 1-3 years of experience in a
high-volume, interactive customer service or call center environment,
with working knowledge of medical terminology; or any combination of
education and experience, which would provide an equivalent background.
To apply for this position, please use the following URL:
https://ars2.equest.com/?response_id=0b9211bc21fdbe00aa1be8be38e3a5a0