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Referral Specialist I (Multiple openings)

Company: Anthem, Inc
Location: Hialeah
Posted on: June 6, 2021

Job Description:


SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Federal Health Products and Services - FHPS, a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Location: Remote opportunity, you must reside within 50 miles of a U.S Anthem location.

The Referral Specialist I (Enrollment) will be responsible for the outreach and enrollment of Disease Management members into Care management programs. During phone calls with members: provide program explanation, collect member demographic and provider information, and schedule follow-up appointments with Nurse or Health Educator for healthcare management.

There are multiple positions available, the hours for the positions would be between 10am-11pm (EST), Monday through Friday.

The potential shifts would be:

10am 6:30pm (EST)

10:30am-7pm (EST)

11am-7:30pm (EST)

2:30pm-11pm (EST)

Training: 3 weeks; 9am-5:30pm Monday through Friday

Primary duties may include, but are not limited to:

+ Make outbound phone calls to members, providing a complete description of our program in a conversational and collaborative manner.

+ Make a connection and engage them in collaborative discussion to understand how the program benefits can best meet their needs.

+ Use assumptive language to drive enrollment and implement strategies as needed to overcome objections to program participation.

+ Provide knowledgeable and accurate information to promote members confidence and value of our program.

+ Communicate with members in a professional and polite manner at all times. This includes maintaining a helpful and engaged tone, building rapport with members, and consistently speaking with appropriate tone, pace, and clarity.

+ Answer inbound calls and utilize open ended questions to promote member centricity. Assist in answering member questions and connecting them with appropriate team member and/or resource.

+ Initiate outreach process by processing referrals received through our health plan portal.

+ Accurately collect and document member information, call result details, and other pertinent information in accordance with policies and procedures.

+ Follow all company and department policies and procedures, including HIPAA and TCPA laws.

+ Meet all department and team expectations for quality, efficiency, and enrollment rate.

+ Consistently demonstrate behaviors that uphold Anthem Values or Leadership, Community, Agility, Integrity, and Diversity.


+ Requires a 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.

Preferred Experience:

+ Experience in customer service experience in healthcare related setting.

+ Telephonic customer service and call center environment experience preferred.

+ Computer skills and demonstrated ability to navigate multiple databases with two monitors is a plus.

Anthem Benefits:

We provide a comprehensive benefits package, including generous PTO, medical, dental and vision plans, 401(k) with a match, education assistance, and much more.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

REQNUMBER: PS46981-Florida

Keywords: Anthem, Inc, Hialeah , Referral Specialist I (Multiple openings), Other , Hialeah, Florida

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