Referral Specialist I

Referral Specialist IA proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug therapies through our specialty pharmacies, our infusion centers, and the home setting. Schedule: Monday-Friday Hybrid: 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.The Referral Specialist I is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals. How you will make an impact: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.Responds to inbound calls initiating exam requests following established processes, meets quality and production standards.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.Additional expectations to include but not limited to: 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 environment; or any combination of education and experience which would provide an equivalent background.Preferred Skills, Capabilities and Experiences: Knowledge of medical terminology preferred.Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.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.The health of our associates and communities is a top priority for Elevance Health. 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. Elevance Health will also follow all relevant federal, state and local laws.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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.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.