Referral Specialist - Full Time

Employment Type: Full time, Day Shift

About the Role

The Referral Specialist manages and facilitates patient referrals, authorizations, and scheduling appointments, tests, and procedures at designated locations. Serving as a liaison between patients, providers, and medical support staff, the referral specialist ensures timely coordination of care by verifying insurance eligibility, obtaining prior authorizations, and entering necessary demographic and insurance information into clinic and hospital systems. The role also includes handling phone communications, supporting referral management operations, and adhering to the mission, vision, and performance expectations of MercyOne Medical Group.

Responsibilities

• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
• Works directly with patients, families, insurance representatives, physicians, and vendors to facilitate the referral process.
• Coordinates, processes, and tracks patient referrals, authorizations, and scheduling with accuracy and attention to detail.
• Verifies insurance coverage, obtains prior authorizations, and communicates approval/denial to patients.
• Schedules patient appointments with appropriate specialists and providers, ensuring timely communication of appointment details.

Requirements

• High school diploma or equivalent required.
• Minimum of 1 year of relevant experience in a healthcare setting required, with prior medical office experience preferred.

Benefits

Colleagues of MercyOne Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout the system. Visit MercyOne Careers to learn more about the benefits, culture, and career development opportunities available.