Referral Specialist I- BioPlus

Referral Specialist I- BioPlus

Referral Specialist I

Location: This role requires associates to be in-office 1 - 2 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.

BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey.

The Referral Specialist I 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:

• Contacts prescriber offices to request refills for established patients.
• Completes outbound calls to patients.
• 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 the pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, etc.) following established processes and procedures.
• Responds to inbound calls initiating exam requests following established processes, meeting quality and production standards.
• Contacts physician offices as needed to obtain demographic information or related data.
• Enters referrals, documents communications, and actions in the 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 Requirements: 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 preferred.
• Pharmacy Technician License strongly preferred.

Job Level: Non-Management Non-Exempt

Workshift: 1st Shift (United States of America)

Job Family: CUS > Care Support