Referral Specialist I

Elevance Health

Las Vegas, Nevada

JOB DETAILS
SKILLS
Clinical Support, Health Plan, Healthcare, Hospital, Magnetic Resonance Imaging (MRI), Medical Office, Procedure Development, Process Development, Product Demonstration, Radiology, Telephone Skills, Work From Home
LOCATION
Las Vegas, Nevada
POSTED
3 days ago
Referral Specialist I

Location: 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.

Hours: Associate will be assigned a shift between 6:30 AM and 6:00 PM Pacific time. Please adjust for your time zone. Hours may vary based on business needs. Shifts may include one weekend day.

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:
  • 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 demo

    Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

    Who We Are

    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.

    How We Work

    At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

    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

About the Company

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Elevance Health