Referral Specialist II - Paragon Infusion Centers
Elevance Health
Referral Specialist II - Paragon Infusion Centers
Location: TX-PLANO, 3033 W PRESIDENT GEORGE BUSH HWY, STE 100
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.
The Referral Specialist II 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 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.
- 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 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.
Job Level: Non-Management Non-Exempt
Workshift: Job Family: CUS > Care Support
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