Referral Specialist I

extra holidays - extra parental leave
Work set-up: 
Full Remote
Contract: 

Offer summary

Qualifications:

High school diploma or GED required., At least 1 year of experience in a high-volume customer service or call center environment., Knowledge of medical terminology is preferred., Experience in healthcare industry or inbound call centers is a plus..

Key responsibilities:

  • Support clinical teams by managing administrative referrals.
  • Review referral information for completeness and follow up as needed.
  • Verify insurance coverage and complete pre-authorization processes.
  • Respond to inbound calls and document communications in the system.

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Elevance Health XLarge https://www.elevancehealth.com/
10001 Employees
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Job description

Anticipated End Date:

20250807

Position Title:

Referral Specialist I

Job Description:

Referral Specialist I

***$1,000 SignOn Bonus***

Location : This role enables associates to work virtually fulltime, with the exception of required inperson training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports worklife integration, and ensures essential facetoface onboarding and skill development.

Please note that per our policy on hybridvirtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Work Schedule : Must be available for an 8 hour shift between the hours of 7am 8:30pm.

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, is a benefitmanagement leader in Illinois. Our platform delivers significant costofcare savings across an expanding set of clinical domains, including radiology, cardiology and oncology.

As a Referral Specialist I, you will be responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals for various Carelon services.

How you will make an impact :

  • Acts as a liaison between hospital, health plans, physicians, patients, vendors and other referral sources.
  • Reviews referrals for completeness and follows up for additional information if necessary.
  • Assigns escalated referrals to staff as appropriate.
  • Verifies insurance coverage and completes preauthorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures.
  • Responds to inbound calls initiating exam requests following established processes, meets quality and production standards.
  • Contacts physician offices as needed to obtain demographic information or related data.
  • Enters referrals, documents communications and actions in system.
    • Minimum Requirements:

      • Requires HS diploma or GED and a minimum of 1 year of experience in a highvolume, interactive customer service or call center environment; or any combination of education and experience which would provide an equivalent background.
        • Preferred Skills, Capabilities & Experiences :

          • Experience in healthcare industry.
          • Inbound call center experience preferred.
          • Knowledge of medical terminology preferred.
            • For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $18.54hr to $29.07hr.

              Locations: California, Illinois

              In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, nondiscriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

              * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education andor skill level. Even within the range, the actual compensation will vary depending on the above factors as well as marketbusiness considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

              Job Level:

              NonManagement NonExempt

              Workshift:

              1st Shift (United States of America)

              Job Family:

              CUS > Care Support

              Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

              Who We Are

              Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

              How We Work

              At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success for our consumers, our associates, our communities and our business.

              We offer a range of marketcompetitive 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, to name a few.

              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.

              The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patientmemberfacing roles to become vaccinated against COVID19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant 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. 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, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Required profile

Experience

Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Customer Service
  • Teamwork
  • Communication
  • Problem Solving

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