Remote Referral Specialist I – Pre-Auth & Care Access

Anthem Blue Cross & Blue Shield; Columbus (GA); Hybrid; USD 24,000 - 40,000; Full time

Job summary

Elevance Health is seeking a Referral Specialist I to support a clinical team by handling referrals, pre-authorizations, and related administrative tasks. The role involves liaising with hospitals, health plans, physicians, patients, and vendors to ensure complete referrals and timely data collection.

The position requires solid communication skills, healthcare familiarity, and the ability to multitask in a fast-paced environment.

Qualifications

• Requires HS diploma or GED and a minimum of 1 year of experience in a high-volume, interactive customer service or call center environment.

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 following established processes, meets quality and production standards.
• Contacts physician offices to obtain demographic information or related data.
• Enters referrals and documents communications and actions in system.
• Multitasks across calls, texts, and electronic queues while taking notes and talking to customers.

Education

HS diploma or GED

Customer service

Medical terminology

Inbound call center

Job description

Elevance Health is seeking a Referral Specialist I to support a clinical team by handling referrals, pre-authorizations, and related administrative tasks. The role involves liaising with hospitals, health plans, physicians, patients, and vendors to ensure complete referrals and timely data collection.

The position requires solid communication skills, healthcare familiarity, and the ability to multitask in a fast-paced environment.