Referral Specialist

Employment Type: Full time Shift: Day Shift Description: At MercyOne, health care is more than just a doctor’s visit or a place to go when you’re in need of medical attention. Our Mission is based on improving the health of our communities – that means not only when you are sick but keeping you well. MercyOne Siouxland Medical Center has earned more national recognition for quality patient outcomes than any other hospital in the region. The medical center has earned multiple honors for its leadership and excellence in several clinical areas including cardiac care, orthopedic services, vascular surgery, stroke care and cancer care. Want to learn more about MercyOne Siouxland? Click here: Find a Location Sioux City, Iowa (IA), MercyOne Siouxland Join the MercyOne Family! We are looking to hire a Referral Specialist As a Referral Specialist at MercyOne, you will ensure that patients have access to other specialty healthcare providers under their insurance. As a Referral Specialist, you are an expert in understanding various insurance plans and medical services. Furthermore, referral specialists have excellent communication skills, as they not only talk to patients but also act as a liaison between hospitals, healthcare providers, vendors, and physicians. . Receive referral orders and review patient's insurance to determine in-network referral options. Contact insurance companies to verify if prior approval is necessary and completes prior authorizations for referrals and tests as needed. Work with referring office if more information is required and communicate insurance decision to patient. Schedule patients with appropriate physician and/or hospital while accommodating patient's preferences and schedule. Communicate to patient details of appointment as well as requirements and education of upcoming appointments and/or tests. Document appointments, prior authorization approvals, and communications in patient EMR. Responsible for working reports and communicating with physicians and/or hospitals to ensure referral notes and test results are sent back to the referring office to close the loop. Communication with clinic providers, clinic staff and hospital departments as needed to facilitate patient care, patient flow and special needs. Collaborate with peer Clinical Referral Specialists to problem solve and improve the referral process. Maintains required department confidentiality and abides by HIPPA regulations. Provides competent patient care to the above indicated patient populations by obtaining and appropriately interpreting data, making appropriate decisions based on demonstrated knowledge of age-specific growth and development, and appropriately adapting procedures and treatments. Schedule: Full Time Days 8am-4:30 pm General Requirements: Six months of office or customer service experience required, preferably in a medical office setting. OR completion of an Administrative Assistant Diploma Computer experience preferred. Typing speed of 35 words per minute preferred. Ability to maintain a high degree of confidentiality. Ability to perform multiple tasks simultaneously. Education: High school diploma or equivalent; knowledge of medical terminology is preferred. 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 to you at MercyOne Health System circle of care. Visit MercyOne on LinkedIn, Facebook, Instagram, YouTube, and Twitter! Our Commitment to Diversity and Inclusion Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law. Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.