Referral Specialist

at Elevance Health in CHICAGO, Illinois, United States

Job Description

Referral Specialist I

Sign-On Bonus: $1000.00

Location: The ideal candidate for this role will live within 50 miles of a Elevance Health Pulse Point.

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.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $15.17 to $30.32

Locations: California

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

  • 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.
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Job Posting: JC260716253

Posted On: Jun 03, 2024

Updated On: Jun 17, 2024

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