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Referral Specialist I

Anthem, Inc

This is a Full-time position in Los Angeles, CA posted June 15, 2022.

Description SHIFT: Day Job SCHEDULE: Full-time Referral Specialist I Location: Remote Be part of an extraordinary team We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change.

Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Build the Possibilities.

Make an extraordinary impact.

AIM Specialty Health is a benefit-management leader in Illinois and a proud member of Anthem’s family of companies.

Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.

As a Referral Specialist I, you will be responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals for various AIM services.

Sign-On Bonus: $1,000.00 How you will make an impact:
• 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.

Qualifications Minimum Requirements:
• 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.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Anthem.

We require all new candidates to become vaccinated against COVID-19.

If you are not vaccinated, your offer will be rescinded unless you provide
– and Anthem approves
– a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate.

Anthem will also follow all relevant federal, state and local laws.

Anthem, Inc.

has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion.

To learn more about our company and apply, please visit us at careers.antheminc.com.

Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact abilityicareerhelp.com for assistance.

REQNUMBER: 0164933