Referral Specialist II

Elevance Health; Tampa (FL); Remote; USD 10,000 - 60,000; Full time

Job summary

Elevance Health is seeking a Referral Specialist II to support clinical teams by managing referrals and verifying insurance. This virtual role requires a high school diploma and at least one year of experience in healthcare customer service. The position offers a competitive hourly wage and comprehensive benefits.

Benefits

Health insurance

401(k)

Stock purchase plans

Wellness programs

Qualifications

• At least 1 year of experience in a high-volume healthcare customer service or call center environment.
• Experience in fast-paced customer service settings.
• Equivalent education and experience may be considered.

Responsibilities

• Manage administrative aspects of referrals and verify insurance.
• Act as a liaison between hospitals, physicians, insurance plans, and patients.
• Document all communications and actions in the system.

Skills

Knowledge of medical terminology

Customer service

ICD-10 coding

Education

High school diploma or GED

Tools

Smartsheet

Job description

Join to apply for the Referral Specialist II role at Elevance Health.

This position offers a range of $19.99/hr - $31.30/hr, depending on skills and experience. BioPlus Specialty Pharmacy, now part of CarelonRx (formerly IngenioRx), is part of Elevance Health, providing specialized healthcare services.

Role Details

The Referral Specialist II is responsible for supporting clinical teams by managing administrative aspects of referrals, verifying insurance, and ensuring accurate documentation.

Key Responsibilities

• Serve as a first-level SME, handling intake calls, production work, and possibly physician assistance or special projects.
• Act as a liaison between hospitals, physicians, insurance plans, and patients.
• Review complex referrals, follow up for additional information, and assign referrals appropriately.
• Verify insurance coverage and obtain necessary authorizations.
• Contact physician offices for demographic and related data.
• Document all communications and actions in the system.

Minimum Qualifications

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

Preferred Skills

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

Additional Information

This is a virtual role with required in-person training. The salary range for California is $19.99 to $31.30 per hour. Elevance Health offers comprehensive benefits, including health insurance, 401(k), stock purchase plans, and wellness programs.

Elevance Health is an equal opportunity employer and values diversity. Candidates must comply with vaccination requirements for certain roles.