SSM Health is hiring a Referral Coordinator I to coordinate provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. In this role, you will verify insurance coverage and benefits, create price estimates, and ensure plan requirements are met to maximize reimbursement.
What You'll Do
- Attend in-services provided by various health plans.
- Travel to off-site locations as necessary.
- Gather necessary clinical information and process referrals, pre-certification, pre-determinations, and pre-authorizations according to insurance plan requirements.
- Log, track and review managed care approvals and denials.
- Respond in a timely manner to last minute or emergency referrals, additional codes performed during a procedure, or procedural changes for pre-authorizations.
- Verify insurance coverage, benefits and create price estimates, performing re-verifications as needed.
- Work collaboratively with insurance companies, providers and staff to ensure plan requirements have been met prior to patient services being rendered.
- Perform all other duties as assigned.
What We're Looking For
- High School diploma/GED or 10 years of work experience.
Benefits & Compensation
- Paid Parental Leave
- Flexible Payment Options via DailyPay
- Upfront Tuition Coverage through FlexPath Funded
Work Mode
This is a remote position located in MO-REMOTE.
SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law.
