Referral Specialist I

The Elevance Health Companies, Inc.; Chicago (IL); Hybrid; USD 24.000 - 40.000; Vollzeit

Benefits dieser Stelle

A comprehensive benefits package

Incentive and recognition programs

Equity stock purchase and 401k

Zusammenfassung

Elevance Health is seeking a Referral Specialist I to manage clinical referrals for pre-authorization. This role supports virtual work with required in-person training and may include a commuting office location.

The position requires handling referrals, verifying insurance, and coordinating with physicians, health plans, and care teams. Responsibilities include initiating referrals for pre-authorization, following up for missing information, and entering data into the system while multitasking

Qualifikationen

• Requires HS diploma or GED and at least 1 year in a high-volume, interactive customer service or call center.
• Knowledge of medical terminology preferred.
• Healthcare industry experience preferred.
• Inbound call center experience preferred.

Aufgaben

• 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 pre-authorization process for radiology and other imaging exams 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.
• Enter referrals, documents communications and actions in system.
• Associates in this role are expected to multi-task, including handling calls, texts, facsimiles, and electronic queues, while taking notes and speaking to customers.

Kenntnisse

Medical terminology

Healthcare experience

Inbound calls

Customer service

Ausbildung

HS diploma or GED

Jobbeschreibung

Anticipated End Date: 2026-11-07

Position Title: Referral Specialist I

Job Description: Referral Specialist I Location: This role enables associates to work virtually full-time, except for 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hours: Monday through Friday; candidates will be assigned a shift between 7 AM and 8 PM Central time.

How you will make an impact:

• 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 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.
• Enter 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 environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

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

Salary:

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $17.42 - $28.75/hr.

Locations:

Illinois, Virginia

Benefits:

• A comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)

Job Level:

Non-Management

Workshift:

Job Family: CUS > Care Support

Recruitment Statement:

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.