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Referral Specialist - Paragon Healthcare

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  • Job
    Full-time
    Junior Level
  • Palo Alto
    Remote

Requirements

  • Minimum Requirements
  • Requires HS diploma or GED.
  • 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-9 and CPT coding preferred.

Responsibilities

  • Acts as a first level SME
  • Ability beyond intake calls that include working on production-oriented work
  • May include physician assisting and/or special projects
  • 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
  • Assigns 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

FAQs

Do we support remote work?

Yes, we do offer remote work options, but candidates must be within 50 miles or a 1-hour commute from the specified location in Plano, TX, or be located within the state of California.

What qualifications are required for the Referral Specialist position?

The minimum requirement is a high school diploma or GED, along with at least 1 year of experience in a high-volume, interactive customer service or call center within a healthcare environment.

Is knowledge of medical terminology necessary for this position?

Yes, knowledge of medical terminology, plan-specific guidelines, and familiarity with ICD-9 and CPT coding are preferred skills for this role.

What are the primary duties of a Referral Specialist?

Primary duties include acting as a subject matter expert, facilitating complex referrals, acting as a liaison between various stakeholders, verifying insurance coverage, obtaining authorizations, and documenting communications in the system.

What is the salary range for the Referral Specialist position?

The salary range for this position is $17.39 to $31.30, depending on various factors such as geographic location, work experience, education, and skill level.

What benefits does Elevance Health offer to employees?

Elevance Health offers a comprehensive benefits package, including incentive and recognition programs, equity stock purchase options, and 401k contributions, subject to eligibility requirements.

Can the salary range for this position change?

Yes, the salary range may be modified in the future, and actual compensation can vary based on factors such as work experience, education, skill level, and market conditions.

Are there opportunities for career advancement in this role?

While the job description does not specifically mention career advancement opportunities, working in a role like Referral Specialist can provide valuable experience and skills applicable to other positions within the healthcare industry.

What is the application process for the Referral Specialist position?

Candidates interested in applying should submit their applications through the Elevance Health careers page or follow the application instructions provided in the job posting.

Is prior experience in a hospital or clinical setting required?

While not explicitly stated as required, experience in a healthcare environment, including hospitals or clinical settings, would be beneficial for the Referral Specialist role.

Improving the health of humanity

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner.   Our nearly 100,000 associates serve more than 118 million people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health.  We believe that improving health for everyone is possible. It begins by redefining health, reimagining the health system, and strengthening our communities.

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