Referral Specialist II Paragon Home Infusion

Referral Specialist II Paragon Home Infusion

Shift: Mon-Fri 9:00 am-6:00 pm CT

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual 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.

The Referral Specialist II - Paragon Home Infusion 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:

• 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.
• 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.

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 in a healthcare environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

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

Job Level: Non-Management Non-Exempt

Workshift: Job Family: CUS > Care Support