Referral Specialist II - Paragon Healthcare at Elevance Health

Indianapolis, Indiana, United States

Elevance Health Logo
Not SpecifiedCompensation
Junior (1 to 2 years), Mid-level (3 to 4 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, PharmaceuticalsIndustries

Requirements

  • HS diploma or GED
  • Minimum of 1 year of experience in a high-volume, interactive customer service or call center in a healthcare environment (or equivalent combination of education and experience)
  • Ability to multi-task, including handling calls, texts, facsimiles, and electronic queues while taking notes and speaking to customers
  • 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 for virtual and in-person interactions
  • Attentive to details, critical thinker, and problem-solver
  • Demonstrates empathy and persistence to resolve caller issues completely
  • Comfort and proficiency with digital tools and platforms
  • Ability to work a structured schedule with occasional overtime or flexibility, including 1-2 days in-office per week (must reside within reasonable commuting distance from office location)

Responsibilities

  • Provide support to clinical team to facilitate administrative components of clinical referrals
  • Act as first level SME, handling production-oriented work beyond intake calls, including physician assisting and/or special projects
  • Act as liaison between hospital, health plans, physicians, patients, vendors, and other referral sources
  • Review complex referrals for completeness and follow up for additional information if necessary
  • Assign referrals to staff as appropriate
  • Verify insurance coverage and obtain authorizations if needed from insurance plans
  • Contact physician offices to obtain demographic information or related data
  • Enter referrals, document communications and actions in system
  • Perform other duties as assigned

Skills

Referral Processing
Insurance Verification
Authorization Management
Data Entry
Multi-tasking
Customer Liaison
Physician Coordination
Healthcare Documentation

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters
1944Year Founded
$309.4MTotal Funding
IPOCompany Stage
Enterprise Software, Social Impact, HealthcareIndustries
10,001+Employees

Benefits

Medical, dental, & vision insurance
401(k) + match
Paid holidays
Paid Time Off
Incentive bonus programs
Stock purchase plan
Life insurance
Wellness Programs
Financial education resources
Adoption & Surrogacy Assistance
Dependent-care Flexible Spending Account (DCFSA)
Parental Leave
Parental Transition Week
Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.
Lawsuit against CMS over MA Star Ratings could lead to financial penalties.
CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.
Acquisition of CareBridge enhances home health services within Carelon division.
Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.
Predictive analytics support early disease detection, aligning with Elevance's whole health approach.
Telehealth expansion offers opportunities to reach more patients remotely.

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