Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals, Insurance) - Paragon Infusion

Anticipated End Date:

2026-02-28

Position Title:

Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals, Insurance) - Paragon Infusion

Job Description:

Referral Specialist II/Patient Access (Pre & Prior Authorizations, Appeals, Insurance) - Paragon Infusion

Office Location: 3033 W President George Bush HWY., STE 100, Plano, TX 75075

In-Office Requirement: Hybrid 2; This role requires associates to be in-office 3 days per week (Tuesdays, Wednesdays, and Thursdays), fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Schedule: Monday – Friday, 7:00 AM – 7:00 PM Central Time, specific shifts during business hours will be discussed during the hiring process.

• Tuesday, Wednesday, and Thursday are In-Office Days

• Mondays and Fridays are Virtual Eligible

Position Start Date: Monday April 20, 2026

Training Schedule: First 20 days of Employment

Training Period Hours:

• 1st Day Of Employment: 9:00AM - 5:00PM CST

• 2nd Day of Employment - End of Training Period: 8:30AM - 5:00PM CST

Training Period Onsite Expectation:

• 1st Week of Employment: Monday - Thursday (Onsite), Friday (Virtual Eligible)

• 2nd Week of Employment - End of Training Period: Hybrid 2; Tuesday, Wednesday, and Thursday (Onsite), Monday and Friday (Virtual Eligible)

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.

The Referral Specialist II 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.

• Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. 

• Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions;  attentive to details, critical thinker, and a problem-solver;  demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts. 

• Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary. 

• Performs other duties as assigned. 

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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:

• Benefit verification and authorization experience is strongly preferred.

• Knowledge of HCPCS, NDC, CPT, and ICD-10 coding for referral managemen