Full-Time

Referral Specialist 1

Posted on 9/8/2026

Deadline 9/30/26
CareBridge

CareBridge

201-500 employees

Cloud-based EVV and LTSS care management

No salary listed

Plano, TX, USA

Hybrid

Three days on-site per week required; candidates must live within a reasonable commuting distance.

Bachelor's

Category
Medical, Clinical & Veterinary (1)
Required Skills
Medical Terminology
Customer Service

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Requirements
  • A high school diploma or GED and a minimum of 1 year of experience in a high-volume, interactive customer service or call center environment, or an equivalent combination of education and experience.
  • Ability to multitask while handling calls, texts, facsimiles, and electronic queues, taking notes, and speaking with customers simultaneously.
  • Ability to maintain focus during extended periods of sitting and handle multiple tasks in a fast-paced, high-pressure environment.
  • Strong verbal and written communication skills for virtual and in-person interactions.
  • Attention to detail, critical-thinking, problem-solving, empathy, and persistence in resolving caller issues.
  • Comfort and proficiency with digital tools and platforms.
  • Ability to work a structured schedule with occasional overtime or flexibility based on business needs, including working from the office as necessary.
Responsibilities
  • Initiate and manage clinical referrals for pre-authorization.
  • Act as a liaison between hospitals, health plans, physicians, patients, vendors, and other referral sources.
  • Review referrals for completeness and follow up for additional information when necessary.
  • Assign escalated referrals to staff as appropriate.
  • Verify insurance coverage and complete the pre-authorization process for radiology and other imaging exams, including computed tomography, magnetic resonance imaging, magnetic resonance angiography, and positron emission tomography, following established procedures.
  • Respond to inbound calls initiating exam requests while meeting quality and production standards.
  • Contact physician offices as needed to obtain demographic information or related data.
  • Enter referrals and document communications and actions in the system.
  • Perform other duties as assigned.
Desired Qualifications
  • Knowledge of medical terminology and plan-specific guidelines, including International Classification of Diseases and Current Procedural Terminology coding.
  • Experience with healthcare benefit referrals, authorizations, appeals, and cost estimates.
  • Healthcare commercial and government experience.
  • Experience with NextGen.

CareBridge provides a suite of tools and services designed to improve long-term support for individuals living at home. The company works by deploying tablets to high-risk members and using a cloud platform to connect patients, families, and care teams through 24/7 support and electronic visit verification. Unlike many competitors, CareBridge integrates data aggregation and benefit management directly into existing workflows to ensure compliance with federal regulations while lowering costs. The company's goal is to help members maintain their independence and health through continuous communication and high-quality home care.

Company Size

201-500

Company Stage

Acquired

Total Funding

$185.6M

Headquarters

Nashville, Tennessee

Founded

2009

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Simplify Jobs

Simplify's Take

What believers are saying

  • Elevance said in April 2026 CareBridge reduced readmissions by 20% and post-acute costs over 10%.
  • May 2026 Get Connected for Health expanded CareBridge's tablet and virtual-care reach.
  • Carelon's 2026 earnings updates kept emphasizing CareBridge as a growth engine for Medicaid and duals.

What critics are saying

  • Jones v. CareBridge Medical Group filed July 2, 2025 alleges unpaid overtime and Equal Pay Act violations.
  • A Florida collective-action complaint against CareBridge seeks pay for about 400 remote clinicians.
  • Integration into Elevance creates existential customer-loss risk if state Medicaid contracts shift to rivals.

What makes CareBridge unique

  • CareBridge owns Medicaid and dual-eligible LTSS workflows, not generic home health.
  • Its 24/7 virtual support and EVV infrastructure embed deeply into state and plan operations.
  • Elevance completed CareBridge in December 2024, making it a Carelon home-based care anchor.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

401(k) Company Match

Paid Vacation

Paid Holidays

Unlimited Paid Time Off

Flexible Work Hours

Hybrid Work Options

Wellness Program

Growth & Insights and Company News

Headcount

6 month growth

-1%

1 year growth

-1%

2 year growth

0%
Health Newswire
Feb 25th, 2025
Shearwater Health Appoints Mike Tudeen as Chairman of the Board

Under Tudeen's leadership, CareBridge received the "Best in Business" award from the Nashville Business Journal and secured the No. 1 ranking on Inc.'s 5000 Fastest-Growing Companies list.

The Business Journals
Oct 21st, 2024
CareBridge sold to Elevance for $2.7B

Elevance Health (NYSE: ELV) announced its acquisition of CareBridge for $2.7 billion during its Oct. 17 earnings call. CareBridge, a Nashville-based company, will be integrated into Elevance's Carelon division. The deal aims to enhance Carelon's home health services. CareBridge, founded in 2019, posted $2.6 billion in revenue in 2023 and was ranked No. 1 on the Inc. 5000 list of fastest-growing companies.

Forbes
Oct 17th, 2024
Elevance Health Will Add To Carelon Portfolio With Carebridge Acquisition

Elevance Health has signed a deal to purchase Carebridge, a manager of home care and community-based services, the health insurer's chief executive said Thursday.

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NASHVILLE, Tenn., Feb. 12, 2024 /PRNewswire/ -- Today, Russell Street Ventures, an innovative healthcare firm focused on launching and scaling companies that serve some of our nation's most vulnerable and underserved patient populations, announced that Bennett Graham and Puneet Singh were named to Modern Healthcare's 40 Under 40 awards that recognizes the industry's rising stars and next generation of leaders. Both Graham and Singh are executives at Russell Street Ventures' portfolio companies. Bennett Graham. Puneet Singh

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