What are the responsibilities and job description for the Referral Specialist position at MercyOne?
Key Responsibilities (list 5-8)
- 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.
Job Requirements / Qualifications
a. Education / Accreditation / Licensure (required & preferred):
- High school diploma or equivalent required.
b. Experience (required and preferred):
- 2 years of progressively responsible related experience in a healthcare environment required.
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.
