Referral Services Assistant (US)
Elevance Health

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. Primary duties may include, but are not limited to: 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 or equivalent 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. Travels to worksite and other locations as necessary.