COMPANY DESCRIPTION:
Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.

 

DESCRIPTION/RESPONSIBILITIES:
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.

 

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.

EOE.M/F/Disability/Veteran

To apply for this position, please use the following URL:

https://ars2.equest.com/?response_id=e276ec9ce2edf56e7d5444d82191bed8