Referral specialist Jobs in Grand Rapids, MI

Referral Coordinator

Posting Be Remarkable! Work in an organization that focuses on treating the whole person, physically, emotionally and spiritually.

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 workflow 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

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.

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity. EOE including disability / veteran.