
Referral Specialist FT- Hybrid
Des Moines, IAFull-timePosted 2w agoStill listed 2w ago
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Job overview
The Referral Specialist at MercyOne in Des Moines will manage patient referrals, authorizations, and pre‑certifications, ensuring timely specialty service appointments and reimbursement. The role involves coordinating with physicians, patients, and payers, handling communication, scheduling, and database maintenance while providing support for clinic operations.
Skills & qualifications
Skills
Qualifications
Full job description
Employment Type: Full timeShift: Day Shift Description: Posting Job Description
Want to learn more about MercyOne Des Moines? Click here: Find a Location Des Moines, Iowa (IA), MercyOne Des Moines
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:
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Full Time 40hrs a week, On-Site position, Monday - Friday Day shift, flexible schedule, no holidays or weekends.
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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:
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High school diploma or equivalent required.
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2 years of progressively responsible related experience in a healthcare environment required.
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.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.
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