Referral Specialist I

Elevance Health; Atlanta (GA); Remote; USD 10,000 - 60,000; Full time

Job summary

Elevance Health is seeking a Referral Specialist I to manage administrative components of clinical referrals in a remote work setting. Responsibilities include liaising with healthcare providers, reviewing referrals, and ensuring adherence to pre-authorization processes. This role offers flexibility and aims to enhance productivity while promoting work-life integration.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Equity stock purchase

Qualifications

• 1 year of experience in a high-volume customer service or call center.
• Experience in healthcare industry preferred.
• Knowledge of medical terminology preferred.

Responsibilities

• Acts as a liaison between various parties for clinical referrals.
• Reviews referrals for completeness and follows up as needed.
• Verifies insurance coverage and completes necessary processes.

Skills

Customer Service

Communication

Medical Terminology

Education

High School Diploma or GED

Job description

Join to apply for the Referral Specialist I role at Elevance Health

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Join to apply for the Referral Specialist I role at Elevance Health

This range is provided by Elevance Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$18.54/hr - $29.07/hr

Anticipated End Date

2025-06-25

Position Title

Referral Specialist I

Job Description

Referral Specialist I

• $1,000 Sign-On Bonus*
  
  

Location : 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.

Work Schedule : Must be available for an 8 hour shift between the hours of 7am - 7pm CST

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.

As a Referral Specialist I, you will be responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals for various Carelon services.

How you will make an impact

• 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 pre-authorization process for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures.
• Responds to inbound calls initiating exam requests following established processes, meets quality and production standards.
• Contacts physician offices as needed to obtain demographic information or related data.
• Enters referrals, documents communications and actions in system.
  
  

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 & Experiences

• Experience in healthcare industry.
• Inbound call center experience preferred.
• Knowledge of medical terminology preferred.
  
  

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $18.54/hr to $29.07/hr.

Locations: California, Illinois

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
  
  

Job Level

Non-Management Non-Exempt

Workshift

1st Shift (United States of America)

Job Family

CUS > Care Support

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [e-mail] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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