Referral Specialist II, Patient Access - Paragon Healthcare at Elevance Health in Plano, Texas

Job Description:

Be Part of an Extraordinary Team



A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug therapies through our specialty pharmacies, our infusion centers, and the home setting.



Title:
Referral Specialist II - Patient Access



The Referral Specialist II is responsible for providing support to a clinical team to facilitate the administrative components of clinical referrals.



Location:
3033 W President George Bush Highway, Plano, TX 75075 Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.



Work Schedule: This position is a Hybrid role Monday - Friday, 9:00-6:00pm

• 
  Tuesday, Wednesday, Thursday in office.
  
  
  


• 
  Monday and Friday Remote
  
  
  

Build the Possibilities. Make an Extraordinary Impact.




How you will make an impact:

Primary duties may include, but are not limited to:

• 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.
  
  

Minimum Requirements:

• Requires HS diploma or GED.
  
  


• 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 preferred
  
  


• Plan specific guidelines; ICD-9 and CPT coding preferred.
  
  

Apply Now