Anthem In. Case Management Jobs

Job Information

Anthem, Inc. Referral Services Assistant in Grand Prairie, Texas

Description

SHIFT: Day Job

SCHEDULE: Full-time

Aspire Health is an innovative healthcare company focused on becoming the national leader in the palliative care market. Aspire specializes in providing an extra layer of support to patients facing a serious illness through an ambitious palliative care program focused on caring for patients in their homes and outpatient clinics. Aspire’s clinicians (e.g., physicians, nurse practitioners, nurses and social workers) are experts in providing patients with relief from the symptoms, pain, and stress of a serious illness; helping patients and caregivers navigate the healthcare system; guiding patients and caregivers through difficult and complex treatment choices; and providing emotional and spiritual support to patients and their families. Aspire currently operates in multiple markets and is in the process of building a team of professionals to implement its innovative palliative care program across the country.

The Referral Services Assistant is responsible for providing support to clinical team to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional counseling, etc. Primary duties may include, but are not limited to:

  • Initiates and manages clinical referrals for participants registered in a disease management or health program.

  • 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.

  • Assigns referrals to staff. Verifies insurance coverage and obtains authorizations from insurance plans.

  • Maintains database of insurance companies for verification of coverage, accepted plans, and requirements for patient eligibility.

  • Contacts physician offices to obtain demographic information or related data. Enters referrals and documents communications in system.

Qualifications

Requirements:

  • A high school diploma; 1 year of experience in a healthcare environment; or any combination of education and experience, which would provide an equivalent background.

  • Ability to travel may be required.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

REQNUMBER: PS41193

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