Referral Specialist II - Paragon Infusion Centers

Elevance Health•Grand Prairie, TX

5d•Hybrid

About The Position

The Referral Specialist II - Paragon Infusion Centers is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals. 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. A proud member of the Elevance Health family of companies.

Requirements

Requires HS diploma or GED 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.
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.

Nice To Haves

Experience working in a medical office setting highly preferred.
Experience working with payor portals.
NextGen experience.
Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.

Responsibilities

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.
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.
Performs other duties as assigned.