Patient Access: Referral Specialist II

The Elevance Health Companies, Inc.; Plano (TX); Hybrid; USD 38,000 - 52,000; Full time

Job summary

Elevance Health in Plano, TX is seeking a Referral Specialist II in Patient Access to support referrals and coordinate with hospitals, health plans, physicians, patients and vendors. This role combines in-office collaboration with flexible hybrid work to balance productivity and work-life balance.

Minimum qualifications include a HS diploma or GED and at least 1 year in a high-volume healthcare customer service or call center.

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.
• Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.

Responsibilities

• 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.
• Enters referrals, documents communications, actions and other data in system.

Skills

Customer service

Medical terminology

Communication

Education

HS diploma or GED

Job description

Elevance Health in Plano, TX is seeking a Referral Specialist II in Patient Access to support referrals and coordinate with hospitals, health plans, physicians, patients and vendors. This role combines in-office collaboration with flexible hybrid work to balance productivity and work-life balance.

Minimum qualifications include a HS diploma or GED and at least 1 year in a high-volume healthcare customer service or call center.