Referral Specialist - MercyOne River Point Central IA-Day shift-Full time-Onsite

About the role

The Referral Specialist at MercyOne Central Iowa ensures that patients requiring specialty service office visits have their referral needs met promptly and efficiently. This role involves processing referrals, authorizations, and pre-certifications, communicating with patients and physicians, setting up appointments, and coordinating with various departments to secure valid referrals.

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 and coordinate clinic visits, including 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

While not specified, candidates should possess strong interpersonal skills, excellent communication abilities, and the ability to manage multiple tasks effectively.

Skills

Proficiency in healthcare systems, excellent organizational skills, and the ability to work independently and as part of a team are essential.

Benefits

Candidates will be offered a competitive compensation package along with a comprehensive benefits program, including health insurance, retirement plans, and opportunities for professional development within the MercyOne Health System.

Pay

Competitive compensation is provided, reflecting the value MercyOne places on its employees.

Schedule

This is a Full Time position, offering 40 hours per week, with an On-Site position, Monday through Friday, Day shift, and a flexible schedule with no holidays or weekends.