Referral Specialist

7 days ago


Woodland Hills, United States Elevance Health Full time

Job Family: CUS > Care Support

Type:
Date Posted: May 31, 2024

Anticipated End Date: Jun 12, 2024

Reference: JR118718

Description

**Referral Specialist I**

**Sign-On Bonus: $1000.00**

**Build the Possibilities. Make an extraordinary impact.**

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. As a Referral Specialist I, you will be responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals for various Carelon services.

**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 for radiology and other imaging exams (CT, MRI, MRA, PET, et.) following established process and procedures.
- 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.

**Minimum Requirements**:

- Requires High School diploma or GED; 1-3 years of experience in a high-volume, interactive customer service or call center environment, with working knowledge of medical terminology; or any combination of education and experience, which would provide an equivalent background.

Locations: California
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

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.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.



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