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Referral Coordinator - Breast Center

MI_SMHC Trinity Health - Michigan
Grand Rapids, MI Full Time
POSTED ON 3/25/2025
AVAILABLE BEFORE 5/25/2025
Employment Type: Full time Shift: Day Shift Description: Be Remarkable! Work in an organization that focuses on treating the whole person, physically, emotionally and spiritually. Highlights: Day Shift Monday – Friday. No weekends or Holidays. Comprehensive benefit packages available including medical, dental, vision, paid time off and 403B Mercy Health Physician Partners, our multi-specialty physician network, employs more than 500 physicians and advanced practice professionals in, Muskegon, Holland Grand Rapids and the Lakeshore. We serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. Position Summary: The Referral Coordinator maintains, confirms, coordinates and/or secures referrals, authorizations, and pre-certifications for referrals and diagnostic testing, verifies the accuracy and completeness demographics, insurance providers and payers on outgoing and incoming referrals, and follows standard work flow for referral management. What you will do: Properly maintains and tracks referrals from beginning to end. Answers, responds to and documents phone calls, requests and questions from patients, physicians, ancillary services or specialty offices in a timely manner. Assembles information concerning patient’s clinical background and referral needs. Obtains necessary authorization for referrals and diagnostic testing in timely fashion with proper documentation. Works denied claims for missing prior authorization or referral within the EMR system. Confirms payer is in-network with specialist. If not, contacts patient to discuss and make alternate arrangements as necessary per payer guidelines in communication with the care team. Maintains and updates reference materials as they pertain to insurance carriers. Other duties as assigned. What you need: Degree, Education and/or training as medical secretary, medical receptionist, medical assistant preferred. High school graduate/ GED required. Two years’ experience in a medical office required. Extensive knowledge of the insurance market & prior authorization requirements. Billing and coding knowledge and experience preferred. Medical terminology and knowledge of medical office procedures preferred. 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.

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