DescriptionHealthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole.ResponsibilitiesConviva Care Solutions is seeking a hard-working and dedicated Referral Coordinator to prepare and process all managed care referral paperwork, schedules and pre-registers patients for exams and procedures with specialists and providers outside of the primary care physician's office and who is interested in being part of a team that focuses on excellent service to others.This is a Work at Home position; the Referral Coordinator must live in Miami Dade CountyJob Functions
Prepares and processes all managed care referral paperwork.
Gathers pertinent information from physicians, nurse practitioners and nursing staff to complete referrals.
Contacts various offices/facilities to obtain necessary appointments for completing referrals.
Maintains referral records and files documentation.
Responds to patient inquiries regarding health plan referrals.
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Must be bilingual English and Spanish
1 plus years of hands-on healthcare experience in a clinical setting, preferably within the Medicare population
Proficient with Microsoft Office applications including Microsoft Word, Excel and Outlook
Proficient with medical terminology
Experience with Electronic Medical Records
Excellent professional communication abilities, at all levels within the organization and with patients, at all times
This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
2 plus years of Referrals Coordinator experience
Knowledge of ICD 10 and CPT coding
Medical Assistant or Professional State Certifications related to healthcare
Work from Home GuidanceTo ensure Home associates' ability to work effectively, the self-provided internet service of Home Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Working hours : Monday to Friday 7:30AM - 4:30PMAdditional InformationAlert:Conviva, a subsidiary of Humana, values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.Interview Format: MODERN HIREAs part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.Please NoteAssociates are required to be fully COVID vaccinated, including booster, or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home.If progressed to offer, candidates will be required to:
Provide proof of full vaccination, including booster OR
Provide proof of applicable exemption including any required supporting documentation
Medical, religious, and state exemptions will be available.#LI-RemoteScheduled Weekly Hours40Equal Opportunity EmployerIt is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. https://www.eeoc.gov/sites/default/files/migratedfiles/employers/eeocselfprintposter.pdfIf you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact email@example.com for assistance.Full-time