Senior Referral Specialist - Precert & Authorization (Hybrid)

Elevance Health, Inc.; Plano (TX); Hybrid; USD 50,000 - 70,000; Full time

Job summary

Elevance Health in Plano, TX is seeking a Referral Specialist III to support precertification and prior authorization reviews for inpatient and outpatient services. This hybrid role requires in-office presence three days per week.

You will guide callers on contract and benefit eligibility, mentor junior team members, and contribute to audits and process improvements. Strong communication and attention to detail are essential.

Qualifications

• Requires HS diploma or equivalent and 3+ years in healthcare customer service.
• Experience with precertification or prior authorization a plus.
• Strong communication and problem-solving abilities.

Responsibilities

• Perform precertification and prior authorization reviews for inpatient and outpatient services.
• Assist callers with contract and benefit eligibility questions.
• Train and mentor associates to improve service delivery.
• Audit referral performance and document audit statistics.
• Multi-task calls, texts, and electronic queues while taking notes.
• Work hours include in-office days with occasional overtime.

Skills

Customer service

Healthcare experience

Education

HS Diploma or equivalent

Job description

Elevance Health in Plano, TX is seeking a Referral Specialist III to support precertification and prior authorization reviews for inpatient and outpatient services. This hybrid role requires in-office presence three days per week.

You will guide callers on contract and benefit eligibility, mentor junior team members, and contribute to audits and process improvements. Strong communication and attention to detail are essential.