Job Details

You must reside in one of the following states for this position:AL, AR, AZ, GA, IA, ID, IL, IN, KS, KY, LA, MI, MO, MS, NY, OH, OK, PA, SC, TN, TX, UT, WIAmerican Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Iowa, Idaho, Louisiana, and Indiana with planned expansion into other states in 2025. For more information, visit AmHealthPlans.com .Benefits and Perks include: Affordable Medical/Dental/Vision insurance optionsGenerous paid time-off program and paid holidays for full time staffTeleDoc 24/7/365 access to doctorsOptional short- and long-term disability plansEmployee Assistance Plan (EAP)401K retirement accounts with company matchEmployee Referral Bonus ProgramPOSITION SUMMARY: The purpose of this position is to assume primary responsibility for receiving, screening and processing all referral and intake information.ESSENTIAL JOB DUTIES: To perform this job, an individual must perform each essential function satisfactorily, with or without a reasonable accommodation; including, but not limited to:Receives, screens and processes all referral informationPerforms verification of benefits: Verify benefitsVerify payment method and amountObtain prior authorization to ensure that services are reimbursable prior to admissionAssign appropriate payer category to be keyed by facility personnelScan information back to requesting facilityEnsure timely and accurate processing of all referrals/admissionsBack-up for review of potential insurance contractsAdheres to ethical business practices by striving to perform in a manner that conforms to the highest standards of ethical behavior, integrity and honestyTakes initiative and responsibility for decisions as an individual and as a company. Exhibits commitment to personal and companywide goalsEncourages a positive environment and experience for co-workersTreats employees with respect and embraces diversity and demonstrates the ability to work together.Promotes a safe and efficient working environment by adhering to agency policies and proceduresAdheres to departmental and agency dress codes as observed by supervisorPerforms other duties as assigned by supervisor'Required Skills: Communication skills and active listeningRequired Work Experience: Three (3) years experience is a healthcare related environment preferredLicensing/Certification/Education Requirements: High School Diploma requiredOther Requirements: Position may require unscheduled overtime, week-end workMust be willing and able to work flexible hoursTravel requiredRequired Computer Software/Equipment Used: Microsoft Suite including Outlook, Excel, and WordAbility to learn HRIS and/or scheduling systemsStandard Office EquipmentComputerEQUAL OPPORTUNITY EMPLOYER Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.This employer participates in E-Verify.#J-18808-Ljbffr