Humana Referrals Coordinator 2 in Fairmont, Minnesota
The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Under direct clinical supervision, the Referrals Coordinator 2 will process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. Activities do not require evaluation or interpretation of clinical information.
Our Department of Defense Contract requires U.S. citizenship for this position.
40% Processes referrals/authorizations during contingency operations in accordance with established cycle time and quality standards. Enters information into MSR and other required/applicable systems.
Success Criteria: Random audit indicates referrals/authorizations processed in accordance with established cycle time and quality standards.
30% Performs timely and accurate data entry of changes to beneficiary contact information in accordance with established department procedures.
Success Criteria: Random review indicates data entry completed in accordance with established procedures.
20% Prepares and submits reports of findings in accordance with requirements defined by the supervisor and maintains complete and accurate files related to assigned activities.
Success Criteria: Random review of reports indicates compliance with requirements defined by supervisor.
10% Becomes proficient in a variety of skills that enables the associate to respond to unexpected operational needs. Accomplishes other projects and duties as assigned. Participates in process and performance improvement activities.
Success Criteria: Participates in meetings and other venues to improve operational efficiency and effectiveness.
This Role description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this Role description. The individual(s) may be called upon and required to follow other instructions or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives.
Minimum of Associates degree
3 or more years of experience in a customer service position
UM/Coding experience and/or experience with medical terminology
Excellent written and oral communication skills
Organizational skills necessary to effectively manage multiple activities.
Evident problem solving skills utilizing available resources
Demonstrates initiative and attention to detail
Comprehensive knowledge of Microsoft Office Suite to include Word and Excel
Our Department of Defense contract requires U.S. citizenship
If offered a position with Humana Government Business you would be required to go through the eQIP process to obtain Government Security Clearance to work on government systems.
Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) is required
2 years of prior Humana Government Business Referral Coordinator experience
Military health care service experience or working knowledge of TRICARE entitlement/ACD program
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire Text to enhance our hiring and decision-making ability. Modern Hire Text allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive a correspondence inviting you to participate in a Modern Hire Text interview. In this interview, you review a set of interview questions over your phone and you will provide text responses to each question. You should anticipate this interview to take about 15 to 20 minutes. Your text message interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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