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Elevance Health Referral Specialist II – Patient Access – Paragon Healthcare in CINCINNATI, Ohio

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.

Build the Possibilities. Make an Extraordinary Impact.

The Referral Specialist II – Patient Access – Paragon Healthcare 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 experience 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.
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