Referral Specialist I - Paragon Infusion Centers

Referral Specialist I - Paragon Infusion Centers

Location: 3033 W President George Bush HWY, STE 100 Plano, TX 75075

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

The Referral Specialist I - Paragon Infusion Centers is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals

How you will make an impact:

• Initiates and manages clinical referrals for pre-authorization.
• 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 pre-authorization 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.
• 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.
• Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
• 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.

Minimum Qualifications:

• Requires HS diploma or GED and a minimum of 1 year of experience in a high-volume, interactive customer service or call center 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.

Job Level: Non-Management Non-Exempt