Referral Specialist

• Initiates and manages clinical referrals for pre-authorization
• 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 if necessary
• Assigns escalated referrals to staff as appropriate
• Verifies insurance coverage and completes pre-authorization process for imaging exams
• Responds to inbound calls initiating exam requests
• Contacts physician offices as needed to obtain demographic information or related data
• Enters referrals, documents communications and actions in system

Referral Specialist I facilitating clinical referrals for Elevance Health

Referral Specialist I facilitating clinical referrals and managing communication between healthcare providers for Elevance Health. Ensuring proper processing and documentation of insurance authorizations in a remote and hybrid work environment.

• Takes inbound calls from individuals needing support, services, or who may be in crisis
• Performs safety screenings and assessments to discern presence and acuity of risk to the safety of the individual or others
• Develops a plan of action in collaboration with the individual
• Completes appropriate, timely, and accurate documentation of interactions
• Provides linkage follow-up as directed
• Coordinates with other agencies and organizations
• Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations

Crisis & Referral Specialist providing telephonic intervention at Elevance Health

Crisis & Referral Specialist

Crisis & Referral Specialist providing telephonic support and assessments for helpline callers at Elevance Health. Operates within 24-hour call center to assist individuals in crisis.

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Referral Specialist

Crisis & Referral Specialist