Remote Referrals Coordinator - Healthcare Case Management

Humana Inc; Bismarck (ND); Remote; USD 39,000 - 49,000; Full time

Job summary

Humana Inc. is seeking a remote Referrals Coordinator who will handle inbound calls, perform data entry in the medical management system, assign providers, and review benefits and medical necessity as needed. The role requires U.S.

citizenship, interim NBIS clearance, 2 years of customer service or admin/data entry, 2 years of healthcare experience with CPT/ICD knowledge, MS Office proficiency, and EST working hours 8 a.m.–5 p.m. with potential overtime.

Qualifications

• U.S. citizenship required.
• Interim NBIS security clearance.
• Not eligible if living in Puerto Rico.
• 2 years of customer service or administrative/data entry experience.
• 2 years of healthcare experience with CPT/ICD knowledge.
• Proficiency with MS Office and ability to navigate multiple applications.
• Able to work 8 a.m.–5 p.m. EST with potential overtime.

Responsibilities

• Recognize referrals requiring Case Management and pend to reviewer.
• Understand TRICARE benefits and Humana referral processes.
• Contact MTFs and civilian providers to obtain additional information.
• Assign ICD-10 and CPT codes to referrals.

Skills

Customer service

Administrative/data entry

MS Office

Medical terminology

CPT/ICD coding knowledge

Tools

Outlook

Word

PowerPoint

Excel

Job description

Humana Inc. is seeking a remote Referrals Coordinator who will handle inbound calls, perform data entry in the medical management system, assign providers, and review benefits and medical necessity as needed. The role requires U.S.

citizenship, interim NBIS clearance, 2 years of customer service or admin/data entry, 2 years of healthcare experience with CPT/ICD knowledge, MS Office proficiency, and EST working hours 8 a.m.–5 p.m. with potential overtime.