Referral Specialist I-7
Company: Elevance Health
Location: Brea
Posted on: May 27, 2023
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Job Description:
Referral Specialist I-7
Job Family: Customer Care
Type: Full time
Date Posted:May 18, 2023
Req #: JR61388
Location:
CA, WOODLAND HILLS
CA, CARPINTERIA
CA, COSTA MESA
CA, CERRITOS
CA, APPLE VALLEY
CA, CERRITOS
CA, BREA
Description
As proud member of the Elevance Health family of companies, Carelon
Post Acute Solutions, formerly myNEXUS, is the leader in health
resource optimization, focused on transforming how healthcare is
delivered and promoting the advancement of care for the people we
serve.
Referral Specialist I
Working Hours: Mon-Fri, with the possibility of flex and/or weekend
shifts.
Location: This position will work a hybrid model (remote and
office). The ideal candidate will live within 50 miles of one of
our Elevance Health PulsePoint locations.
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:
Primary duties may include, but are not limited to:
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 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 Knowledge:
For candidates working in person or remotely in the below
locations, the salary* range for this specific position is $16 to
$30
Locations: California; Colorado; Nevada; Washington State; Jersey
City, NJ; New York City, NY; Ithaca, NY and Westchester County,
NY
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,
nondiscriminatory 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.
Please be advised that Elevance Health only accepts resumes from
agencies that have a signed agreement with Elevance Health.
Accordingly, Elevance Health is not obligated to pay referral fees
to any agency that is not a party to an agreement with Elevance
Health. Thus, any unsolicited resumes, including those submitted to
hiring managers, are deemed to be the property of Elevance
Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives
and communities - and making healthcare simpler. A Fortune 20
company with a longstanding history in the healthcare industry, we
are looking for leaders at all levels of the organization who are
passionate about making an impact on our members and the
communities we serve. You will thrive in a complex and
collaborative environment where you take action and ownership to
solve problems and lead change. Do you want to be part of a larger
purpose and an evolving, high-performance culture that empowers you
to make an impact?
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.
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.
If you are not vaccinated, your offer will be rescinded unless you
provide - and Elevance Health approves - a valid religious or
medical explanation as to why you are not able to get vaccinated
that Elevance Health is able to reasonably accommodate. Elevance
Health will also follow all relevant federal, state and local
laws.
Elevance Health has been named as a Fortune Great Place To Work in
2022, has been ranked for five years running as one of the 2023
World's Most Admired Companies by Fortune magazine, and is a
growing Top 20 Fortune 500 Company. To learn more about our company
and apply, please visit us at careers.ElevanceHealth.com. 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
ability@icareerhelp.com for assistance.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
Please use the links below to review statements of protection from
discrimination under Federal law for job applicants and
employees.
EEO Policy Statement
Know Your Rights
Pay Transparency
Privacy Notice for California Residents
Elevance Health, Inc. is anE-verify Employer
(https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)
Need Assistance?
Email us (elevancehealth@icareerhelp.com) or call
1-877-204-7664
Keywords: Elevance Health, Fullerton , Referral Specialist I-7, Other , Brea, California
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