Referral Specialist II - Paragon Infusion Centers

The Referral Specialist II - Paragon Infusion Centers is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals. This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Shift

• Shift: 8:00 am - 5:00 pm CT
• Hybrid: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Onsite Days

• Tuesday, Wednesday, Thursday

Responsibilities

• Acts as liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
• Reviews complex referrals for completeness and follows up for additional information if necessary.
• Sets referrals to staff as appropriate.
• Verifies insurance coverage and obtains authorizations if needed from insurance plans.
• Contacts physician offices as needed to obtain demographic information or related data.
• Enters referrals, documents communications and actions in system.
• Enters referrals, documents communications, actions and other data in system.
• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
• Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment.
• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.
• Performs other duties as assigned.

Qualifications

• Requires HS diploma or GED and a minimum of 1 year of experience in a high-volume, interactive customer service or call center in a healthcare environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, And Experiences

• Knowledge of medical terminology, plan specific guidelines; ICD and CPT coding.
• Experience with healthcare benefit referrals, authorizations, appeals, and cost estimates.
• Healthcare Commercial and Government experience.
• NextGen experience.

Benefits

• Elevance Health offers a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement).
• Medical, dental, vision, short and long term disability benefits.
• 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources.

Policies and Procedures

• Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week.
• Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

COVID-19 Vaccination Requirement

• Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.
• Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
• Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.
• Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Equal Employment Opportunity

• Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Legal Compliance

• Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.