Referral Specialist II

Elevance Health; Indianapolis (IN); Hybrid; USD 10,000 - 60,000; Full time

Job summary

Elevance Health is seeking a Referral Specialist II to support a clinical team by managing administrative aspects of clinical referrals. This virtual role involves acting as a liaison among various stakeholders, verifying insurance coverage, and ensuring the completeness of referrals. Candidates should have a high school diploma and at least one year of relevant experience in a healthcare customer service environment.

Benefits

Comprehensive benefits

Incentive programs

401k

Stock purchase options

Qualifications

• At least 1 year of experience in a high-volume healthcare customer service or call center environment.
• Background in pharmacy, especially home infusion or specialty pharmacy, is strongly preferred.
• Experience in a fast-paced customer service environment is preferred.

Responsibilities

• Manage administrative aspects of clinical referrals.
• Act as a liaison between hospitals, health plans, physicians, patients, vendors, and referral sources.
• Review complex referrals for completeness and follow up for additional information.

Skills

Knowledge of medical terminology

Customer service

ICD-10 coding

Experience with spreadsheets

Communication

Education

HS diploma or GED

Tools

Smartsheet

Job description

Join to apply for the Referral Specialist II 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

$19.99/hr - $31.30/hr

Position Title

Referral Specialist II

Job Description

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that's easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer's treatment journey.

Referral Specialist II - Home Infusion/Specialty Pharmacy

This role is virtual, enabling associates to work full-time remotely, with required in-person training sessions for onboarding and skill development.

The Referral Specialist II supports a clinical team by managing administrative aspects of clinical referrals.

How you will make an impact

• Act as a first-level SME, handling intake calls, production work, physician assistance, and special projects.
• Serve as liaison between hospitals, health plans, physicians, patients, vendors, and referral sources.
• Review complex referrals for completeness and follow up for additional information.
• Assign referrals to staff appropriately.
• Verify insurance coverage and obtain authorizations as needed.
• Contact physician offices for demographic or related data.
• Enter referrals and document communications and actions in the system.

Minimum Requirements

HS diploma or GED and at least 1 year of experience in a high-volume healthcare customer service or call center environment, or equivalent education and experience.

Preferred Skills, Capabilities, and Experiences

• Knowledge of medical terminology and plan-specific guidelines; ICD-10 coding preferred.
• Experience with spreadsheets and Smartsheet preferred.
• Background in pharmacy, especially home infusion or specialty pharmacy, is strongly preferred.
• Experience in a fast-paced customer service environment is preferred.

Location: California

Salary range for this position is $19.99 to $31.30 per hour, based on experience and qualifications.

Additional Information

Elevance Health offers comprehensive benefits, incentive programs, 401k, stock purchase, and more. The company follows a Hybrid Workforce Strategy, requiring some onsite presence. All candidates must be vaccinated against COVID-19 and Influenza unless an exemption is provided.

Elevance Health is an Equal Opportunity Employer, considering all qualified applicants without discrimination.