Referral Specialist II

The Elevance Health Companies, Inc.; Plano (TX); Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Bonus programs

Job summary

Elevance Health is seeking a Referral Specialist II to support a clinical team with the administrative components of referrals. The role balances in-office collaboration 1–2 days/week with flexible virtual work, and alternate locations are possible for commuting candidates.

You will act as a liaison among hospitals, health plans, physicians, patients, and vendors, ensuring referrals are complete and properly assigned. Strong communication and attention to detail are essential.

Qualifications

• HS diploma or GED with 1+ year experience in high-volume healthcare customer service.
• Experience in a healthcare environment handling referrals or administrative tasks.
• Strong communication and phone/email handling skills.

Responsibilities

• Act as first level SME, handling production oriented work and special projects.
• Serve as liaison among hospitals, health plans, physicians, patients, vendors and referrals.
• Review complex referrals for completeness and follow up for missing data.
• Assign referrals to staff and coordinate with care teams.
• Verify insurance coverage and obtain authorizations when needed.
• Enter referrals and document communications in the system.
• Multi-task across calls, texts, and queues while taking notes.

Skills

Customer service

Healthcare experience

Communication skills

Empathy and problem solving

Medical terminology

ICD-9 and CPT coding

Education

HS diploma or GED

Job description

Referral SpecialistII

Anticipated End Date: 2026-09-30

Position Title: Referral SpecialistII

Job Description: The Referral SpecialistII will be responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals.

Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

How you will make an impact

• Acts as a first level SME, with ability beyond intake calls that include working on production oriented work, which 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.
• 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.
• 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 in a healthcare environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• Knowledge of medical terminology and plan specific guidelines.
• ICD‑9 and CPT coding.

Job Level, Workshift and Job Family

Job Level: Non‑Management

Workshift: Non‑Exempt

Job Family: CUS > Care Support

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• 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
• Financial education resources

Hybrid Workforce Strategy

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.

Vaccination Policy

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.

Equal Employment Opportunity

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.

Accommodation Request

Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Criminal History Policy

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.

Florida Law Screening

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

Contact

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.