Join the MercyOne Family! We are looking to hire a Referral Specialist!

As a Referral Specialist at MercyOne, you will work with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits. Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement.

Schedule: 

• Full Time 40hrs a week, Potential Hybrid/Remote in the future. This would still be on-site training/work, with potential hybrid and or remote in future, Monday - Friday day shift, flexible schedule, no holidays or weekends.

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

General Requirements: 

• Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.

• Communicate detailed information and answers patients' questions regarding their health care plan; provide answers to billing and insurance clarification questions.

• Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.

• Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient.

• Enter referrals, documents communications and action into the system, as appropriate.

• Notify physician(s) and patient when referral is denied, or if additional information is needed.

• Develop and maintain database of referral physician offices preferred by each physician within the clinic.

• Assist Practice Manager with complaint resolution and solutions related to patient referrals.

• Perform other duties as assigned by the practice manager or physician.

 Education: 

• High school diploma or equivalent required.

• 2 years of progressively responsible related experience in a healthcare environment required.