Referral Coordinator/HIMS

At Humana, we are dedicated to providing exceptional healthcare solutions to our members. As a Referral Coordinator/HIMS, you will play a crucial role in ensuring our members receive the proper care they need. You will be responsible for coordinating referrals for medical services and maintaining accurate health information in our system. To excel in this position, you must possess strong organizational skills, attention to detail, and the ability to communicate effectively with both internal and external stakeholders. If you are passionate about helping others and have experience in healthcare administration, we invite you to join our team at Humana.

1. Coordinate referrals for medical services: The Referral Coordinator/HIMS will be responsible for efficiently coordinating and managing referrals for medical services for Humana members. This includes ensuring timely processing of referrals, obtaining necessary authorizations, and scheduling appointments.
2. Maintain accurate health information: The Referral Coordinator/HIMS will be responsible for maintaining accurate and up-to-date health information in our system. This includes verifying member eligibility, updating medical records, and ensuring all necessary documentation is complete.
3. Communicate with internal and external stakeholders: This role requires effective communication with both internal and external stakeholders, including healthcare providers, insurance companies, and members. The Referral Coordinator/HIMS must be able to communicate clearly and professionally to ensure all parties are informed and updated throughout the referral process.
4. Ensure exceptional healthcare solutions: At Humana, we are committed to providing exceptional healthcare solutions to our members. The Referral Coordinator/HIMS plays a vital role in this by ensuring that members receive the proper care they need through timely and accurate referral coordination.
5. Demonstrate strong organizational skills: This position requires a high level of organization and attention to detail to effectively manage multiple referrals and maintain accurate health information. The Referral Coordinator/HIMS must be able to prioritize tasks and meet deadlines in a fast-paced environment.
6. Uphold confidentiality and privacy standards: The Referral Coordinator/HIMS will handle sensitive health information and must adhere to confidentiality and privacy standards to protect our members' privacy and ensure compliance with HIPAA regulations.
7. Collaborate with team members: The Referral Coordinator/HIMS will work closely with other team members to ensure a smooth and efficient referral process. This may include collaborating with other departments, such as customer service or billing, to resolve any issues or concerns that may arise.
8. Continuously improve processes: As a critical member of our team, the Referral Coordinator/HIMS will be expected to identify areas for improvement in the referral process and suggest solutions to enhance efficiency and effectiveness.

According to JobzMall, the average salary range for a Referral Coordinator/HIMS in Houston, TX, USA is between $55,000 and $70,000 per year. However, this can vary depending on factors such as education, experience, and specific job responsibilities.

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.