Remote Referral Specialist I: Clinical Coordination

Elevance Health, Inc.; Chicago (IL); Hybrid; USD 24,000 - 40,000; Full time

Job summary

Elevance Health is seeking a Referral Specialist I to support a clinical team by coordinating administrative aspects of referrals, pre-authorization, and liaison with hospitals, physicians, patients and vendors.

This role emphasizes strong multitasking, meticulous attention to detail, and clear communication in a hybrid/virtual work environment with occasional in-person training and shifts between 7 AM and 8 PM Central time.

Qualifications

• HS diploma or GED plus 1 year in a high-volume, interactive customer service or call center environment.
• Healthcare experience preferred.

Responsibilities

• 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 and meets quality and production standards.
• Contacts physician offices to obtain demographic information or related data.
• Enters referrals and documents communications in the system.
• Maintains focus while multi-tasking in a fast-paced environment and demonstrates empathy and problem-solving to resolve issues.

Skills

Medical terminology

Healthcare industry

Inbound call center experience

Job description

Elevance Health is seeking a Referral Specialist I to support a clinical team by coordinating administrative aspects of referrals, pre-authorization, and liaison with hospitals, physicians, patients and vendors.

This role emphasizes strong multitasking, meticulous attention to detail, and clear communication in a hybrid/virtual work environment with occasional in-person training and shifts between 7 AM and 8 PM Central time.