Be Part of an Extraordinary TeamA 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 IILocation: Candidates must reside within 50 miles or 1-hour commute each way of 3033 W President George Bush Hwy STE 100, Plano, TX 75075Shift: Monday-Friday; Associates will be assigned a shift between the hours of 7AM CST - 6PMCSTBuild the Possibilities. Make an Extraordinary Impact.The Referral Specialist II- Patient Access 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: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.
Enters referrals, documents communications, actions and other data in system.
Minimum 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.
Preferred Skills, Capabilities and Experiences:
Knowledge of medical terminology, plan specific guidelines; ICD-9 and CPT coding preferred.
