Referral Specialist

Trinity Health Corp.; Mason City (IA); On-site; USD 35,000 - 48,000; Full time

Benefits offered by this job

Full benefits package

Job summary

MercyOne Health System is seeking a Referral Specialist to manage patient referrals, authorizations, and scheduling across designated locations. The role serves as a liaison among patients, providers, and medical staff to ensure timely care coordination and accurate data entry in clinic and hospital systems.

Responsibilities include verifying insurance eligibility, obtaining prior authorizations, and communicating approvals or denials to patients.

Qualifications

• High school diploma or equivalent required.
• Minimum of 1 year of relevant experience in a healthcare setting required, with prior medical office experience preferred.

Responsibilities

• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
• Works directly with patients, families, insurance representatives, physicians, and vendors to facilitate the referral process.
• Coordinates, processes, and tracks patient referrals, authorizations, and scheduling with accuracy and attention to detail.
• Verifies insurance coverage, obtains prior authorizations, and communicates approval/denial to patients.
• Schedules patient appointments with appropriate specialists and providers, ensuring timely communication of appointment details.

Skills

Patient interaction

Healthcare experience

Attention to detail

Phone communications

Education

High school diploma or equivalent

Job description

Employment Type:

Full time

Shift:

Day Shift

Description:

Position Title:

Referral Specialist

Position Purpose:

The Referral Specialist manages and facilitates patient referrals, authorizations, and scheduling appointments, tests, and procedures at designated locations. Serving as a liaison between patients, providers, and medical support staff, the referral specialist ensures timely coordination of care by verifying insurance eligibility, obtaining prior authorizations, and entering necessary demographic and insurance information into clinic and hospital systems. The role also includes handling phone communications, supporting referral management operations, and adhering to the mission, vision, and performance expectations of MercyOne Medical Group.

Job Duties:

• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
• Works directly with patients, families, insurance representatives, physicians, and vendors to facilitate the referral process.
• Coordinates, processes, and tracks patient referrals, authorizations, and scheduling with accuracy and attention to detail.
• Verifies insurance coverage, obtains prior authorizations, and communicates approval/denial to patients.
• Schedules patient appointments with appropriate specialists and providers, ensuring timely communication of appointment details.

Minimum Qualifications:

• High school diploma or equivalent required.
• Minimum of 1 year of relevant experience in a healthcare setting required, with prior medical office experience 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’s 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.