Referral Specialist - Full time-Days-MercyOne River Point Central IA-Hybrid

About the role

The Referral Specialist at MercyOne Central Iowa works with patients needing referrals for specialty service office visits. They process referrals, authorizations, and pre-certifications to ensure timely reimbursement.

Responsibilities

• Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.
• Communicate detailed information and answer patients' questions regarding their health care plan; provide answers to billing and insurance clarification questions.
• Schedule appointments, coordinate clinic visits, and make special arrangements such as transportation, interpreter services, specialty care, etc.
• Carefully coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patients.
• Enter referrals, documents communications and actions into the system, as appropriate.
• Notify physician(s) and patient when referral is denied, or if additional information is needed.
• Develop and maintain a database of referral physician offices preferred by each physician within the clinic.
• Aid the Practice Manager with complaint resolution and solutions related to patient referrals.
• Perform other duties as assigned by the practice manager or physician.

Requirements

• A high school diploma or equivalent is required.
• Two years of progressively responsible related experience in a healthcare environment are required.

Qualifications

Must be able to come on-site to the Des Moines office (405 SW 5th St. Des Moines, IA).

Skills

• Excellent communication skills
• Strong organizational skills
• Ability to work independently and as part of a team

Benefits

MercyOne offers a full benefits package including competitive compensation, growth opportunities, and a supportive work environment.

Pay

Competitive compensation package.

Schedule

Full Time 40 hours a week, with potential for hybrid/remote work in the future. Monday - Friday day shift, flexible schedule, no holidays or weekends.