COMPANY DESCRIPTION:

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

DESCRIPTION/RESPONSIBILITIES:

The Referral Specialist will be 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:

Required:

• 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=3df2473ded0a5b51ff57595210db50b9