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Referral Specialist - Des Moines Internal Medicine Clinic

Company: Mercy Medical Center
Location: Des Moines
Posted on: February 17, 2020

Job Description:

Position Type: Regular

Scheduled Hours per 2 week Pay Period: 80

Primary Location: IA > DES MOINES > MERCY MEDICAL CENTER

Job Summary / Job Purpose:

The Referral Specialist works 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.

Key Responsibilities:

* 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:

* Education / Accreditation / Licensure (required & preferred):
* High school diploma or equivalent required.
* Experience (required and preferred):
* 2 years of progressively responsible related experience in a healthcare environment required.

Additional Information

* Requisition ID: 2020-R0273590
* Schedule: Full-time
* Market: Mercy Medical Center

Keywords: Mercy Medical Center, Des Moines , Referral Specialist - Des Moines Internal Medicine Clinic, Healthcare , Des Moines, Iowa

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