Elevance Health-posted 27 days ago
$19 - $30/Yr
Full-time • Entry Level
Remote • Rancho Cordova, CA
5,001-10,000 employees
Insurance Carriers and Related Activities

Referral Services Assistant Location: Virtual: This role enables associates to work virtually full-time (Indiana, Illinois, California, Texas, or Tennessee) , 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 Work Schedule : An 8 hour shift based on the needs of the business. The hours of operation are Monday - Friday, between 7 am - 8 pm CST. Hours of operation on Saturday and Sunday are 8 am - 12pm CST. The Referral Services Assistant is responsible for providing support to 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.

  • 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.
  • Requires a HS diploma 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.
  • Computer proficiency and the ability to navigate Microsoft Office products, especially Excel preferred.
  • Strong communication and multi-tasking skills preferred
  • Call center experience preferred.
  • Health insurance or medical office experience preferred.
  • Schedule flexibility with the availability for overtime preferred.
  • 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).
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