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

About the role

The Referral Specialist at MercyOne Central Iowa ensures that patients requiring specialized care have their referral needs met promptly and efficiently. They collaborate with physicians, patients, and payers to process referrals, authorizations, and pre-certifications, ensuring 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 arrange special arrangements like transportation and interpreter services.
• Coordinate communication between the medical clinic and the referral authorization department to secure a valid referral for the clinic patient.
• Enter referrals, document communications, and actions into the system as appropriate.
• Notify physician(s) and patient when a referral is denied or additional information is needed.
• Develop and maintain a database of preferred referral physician offices for each physician within the clinic.
• Aid in complaint resolution and problem-solving 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

Strong communication skills, organizational abilities, and the ability to manage multiple tasks simultaneously are essential.

Benefits

MercyOne offers a comprehensive benefits package including competitive compensation, full benefits, and opportunities for growth within the system.

Pay

Competitive compensation is offered based on experience and qualifications.

Schedule

This position is full-time, 40 hours per week, with potential for a hybrid or remote work arrangement in the future. The role requires on-site training and work, with flexibility in scheduling, no holidays or weekends.