Referral Services Assistant

Referral Services Assistant

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. An 8 hour shift based on the needs of the business. The hours of operation are Monday - Friday: 8:00am - 4:30pm PST, 10:00am - 6:30pm CST, 11:00am - 7:30pm EST.

The Referral Services Assistant is responsible for providing support to the clinical team to facilitate the administrative components of clinical referrals for case management or disease management services to include home health, nutritional counseling, etc.

How you will make an impact:

• Initiates and manages clinical referrals for participants registered in a disease management or health program.
• 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.
• Assigns referrals to staff.
• Verifies insurance coverage and obtains authorizations from insurance plans.
• Maintains database of insurance companies for verification of coverage, accepted plans, and requirements for patient eligibility.
• Contacts physician offices to obtain demographic information or related data.
• Enters referrals and documents communications in system.
• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers.
• Additional expectations to include but not limited to: 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, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts.
• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary.
• Performs other duties as assigned.

Minimum Requirements:

• Requires a HS diploma or equivalent and a minimum of 1 year of experience in a healthcare environment; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities & Experiences:

• Outbound call center experience preferred.
• Preauthorization experience preferred.
• Experience using Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) in a professional setting.
• Strong computer literacy with the ability to manager multiple software programs simultaneously.
• Ability to enter and manage data accurately across various platforms.
• Strong communication skills preferred.
• Medical terminology preferred.

For candidates working in person or virtually in the below location(s), the salary range for this specific position is $15.17 to $30.34/hr. Locations: California, Illinois, Maryland, Washington State.

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.

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. 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. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. 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 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. 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 elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.