Remote Referrals Coordinator | Healthcare Data Review

Humana; United States; À distance; USD 39 000 - 49 000; Plein temps

Résumé du poste

Humana is seeking a remote Referrals Coordinator to support the healthcare team. You will handle data entry in the medical management system, review benefits, assign providers, and pend cases to nurses or supervisors when additional information is needed.

The role requires healthcare terminology knowledge, CPT/ICD familiarity, and strong MS Office skills. You must be able to work 8-hour EST shifts and comply with security clearances and DoD contract requirements.

Qualifications

• U.S. citizenship required by DoD contract.
• Must obtain interim government security clearance (NBIS).
• No work in Puerto Rico under the current contract.
• 2+ years of customer service or administrative/data entry experience.
• 2+ years of healthcare experience with CPT/ICD terminology knowledge.
• Proficient with MS Office and ability to navigate multiple applications.

Responsabilités

• Recognize sensitive diagnoses or referrals requiring Case Management and pend to the appropriate contact.
• Understand TRICARE benefits/limitations and Humana Military referral processes, MOUs with MTFs, and referral/UM policies.
• Answer questions or contact MTFs and civilian providers to obtain information for referrals.
• Assign appropriate ICD10 and CPT codes to referrals.

Connaissances

Customer service experience

Administrative/data entry

Healthcare terminology

CPT/ICD codes knowledge

MS Office proficiency

EST shift availability

Outils

MS Office Suite

Description du poste

Humana is seeking a remote Referrals Coordinator to support the healthcare team. You will handle data entry in the medical management system, review benefits, assign providers, and pend cases to nurses or supervisors when additional information is needed.

The role requires healthcare terminology knowledge, CPT/ICD familiarity, and strong MS Office skills. You must be able to work 8-hour EST shifts and comply with security clearances and DoD contract requirements.