Remote - Full Time

Job Description Summary

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Phone Team RSAs (Referral Services Assistants) manage daily inbound calls related to prior authorizations, guiding callers through submission processes, updates, and approvals in alignment with department guidelines. They collaborate with clinical teams, production RSAs, and internal departments to resolve inquiries efficiently while delivering a high-quality customer experience.

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How will you make an impact & Requirements

Referral Services Assistant

Phone Team RSA’s (Referral Services Assistant) handle daily inbound calls related to prior authorization requests. Their core responsibilities include:

Guiding callers through the process of submitting authorization requests
Assisting with modifications or cancellations of existing authorizations
Communicating the status of authorization requests clearly and efficiently
Approving eligible authorizations in accordance with departmental guidelines

Phone Team RSAs collaborate closely with:

Production RSAs
Clinical teams including RNs and MD reviewers
Internal support departments
This cross-functional teamwork ensures timely and accurate resolution of provider inquiries while maintaining a high standard of customer service.

Skills & Experience

Proven experience in a Call Center environment
Solid understanding of medical terminology
Background in the healthcare industry is essential
Prior Utilization Management (UM) experience is strongly preferred
Strong proficiency in navigating multiple systems and databases
Analytical mindset with strong problem-solving abilities
Ability to stay calm and professional in high-pressure situations
Demonstrates initiative, independence, and ownership in day-to-day tasks

Shift: Monday-Friday 8 AM-5 PM Pacific Standard Time

Compensation: $19.38/hr. - $25.50/hr. & bonus eligible

Carelon Health jobs

Referral Services Assistant