Hybrid Referral & Authorization Specialist I

Elevance Health; Chicago (IL); Hybrid; USD 26,000 - 39,000; Full time

Job summary

Elevance Health in Chicago, IL is seeking a Referral Specialist I to support a clinical team by handling the administrative components of referrals, pre-authorization, and communications with hospitals, physicians, and patients.

This hybrid role requires in-office presence three days a week at 8600 Bryn Mawr Ave and offers a flexible schedule with virtual work to promote productivity, accuracy, and patient care.

Qualifications

• HS diploma or GED with at least 1 year in a high-volume customer service or call center.
• Healthcare or medical terminology familiarity is preferred.
• Strong verbal and written communication and attention to detail.

Responsibilities

• Validate appeal requests and initiate/manage clinical referrals for pre-authorization.
• Serve as liaison among hospital, health plans, physicians, patients and vendors.
• Triages mail and reviews referrals for completeness, follows up as needed.
• Open/close appeal requests, assign escalated referrals to staff appropriately.
• Verify insurance coverage and complete pre-authorizations for imaging exams.
• Respond to inbound calls, initiate exam requests, meet quality/production standards.
• Contact physician offices to obtain demographic data and other details.
• Enter referrals and document communications in the system.

Skills

Customer service

Medical terminology

Healthcare experience

Communication skills

Education

HS diploma or GED

Job description

Elevance Health in Chicago, IL is seeking a Referral Specialist I to support a clinical team by handling the administrative components of referrals, pre-authorization, and communications with hospitals, physicians, and patients.

This hybrid role requires in-office presence three days a week at 8600 Bryn Mawr Ave and offers a flexible schedule with virtual work to promote productivity, accuracy, and patient care.