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Elevance Health Referral Specialist II in Colorado Springs, Colorado

Referral Specialist II

  • Location: CO, Colorado Springs

  • Job Family: CUS > Care Support

  • Type: Full time

  • Date Posted:Jun 23, 2022

  • Req #: PS71984

Description

Sign On Bonus $500

Referral Specialist I/II

Responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals for various AIM services.

Referral Specialist I

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

Referral Specialist II

Primary duties may include, but are not limited:

+ + Acts as a first level SME, ability beyond intake calls that include working on production oriented work, may include physician assisting and/or special projects.

+ + Acts as liaison between hospital, health plans, physicians, patients, vendors and other referral sources.

+ + Reviews complex referrals for completeness and follows up for additional information if necessary.

+ + Assigns referrals to staff as appropriate.

+ + Verifies insurance coverage and obtains authorizations if needed from insurance plans.

+ + Contacts physician offices as needed to obtain demographic information or related data.

+ + Enters referrals, documents communications and actions in system.

+ + Enters referrals, documents communications, actions and other data in system.

Here’s what Elevance Health offers:

  • A career path with opportunity for growth

  • Ability to obtain your Associate’s or Bachelor’s degree or further your education with tuition reimbursement.

  • Affordable Health Insurance, Dental, Vision and Basic Life

  • 401K match, Paid Time Off, Holiday Pay

  • Quarterly incentive bonus and annual increases plan based on performance.

At Elevance Health the team is comprised of the best and the brightest from diverse experiences, cultures, and backgrounds. The differences we each bring to the table are a part of what makes our company so successful.

Referral Specialist I

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.

  • Ability to work 8-4:30 MT/10-7:30 ET.

Referral Specialist II

Minimum Requirements:

  • Requires HS diploma or GED and a minimum of 1 year experience and a minimum of 1 year of experience in a high-volume, interactive customer service or call center in a healthcare environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.

  • Ability to work 8-4:30 MT/10-7:30 ET.

Preferred Skills, Capabilities and Experiences:

  • Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.

  • Ability to work 8-4:30 MT/10-7:30 ET.

  • Applicable to Colorado Applicants Only

Hourly Pay Range*: $17.49/hr - $21.86/hr (Min – MRP)

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

  • The hourly or 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. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. 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 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. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

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 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 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.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 contactability@icareerhelp.comfor assistance.

EEO is the LawEqual 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

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  • EEO Poster Supplement-English Version

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Elevance Health, Inc. is an E-verify Employer

Need Assistance?Email us (elevancehealth@icareerhelp.com) or call 1-877-204-7664

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