Referral Coordinator
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Referral Coordinator coordinating SSM Health patient referrals, pre-certifications, and insurance authorizations. Verifying coverage and collaborating with providers to ensure timely care.
Responsibilities:
- Attend in-services provided by various health plans
- Travel to off-site locations as necessary
- Gather clinical information and process referrals, pre-certifications, pre-determinations, and pre-authorizations according to insurance plan requirements
- Log, track, and review managed care approvals and denials
- Respond to last-minute or emergency referrals, additional procedure codes, and procedural changes for pre-authorizations
- Verify insurance coverage and benefits
- Create price estimates and perform reverifications as needed, including first-of-the-month reverifications for managed Medicaid plans
- Collaborate with insurance companies, providers, and staff to ensure plan requirements are met before patient services are rendered and maximize reimbursement
- Perform other duties as assigned
Requirements:
- High School diploma/GED or 10 years of work experience
- No experience required
- Must reside within one hour of the location
- Frequent keyboard use/data entry
- Ability to hear alarms, malfunctioning machinery, etc.
- Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
- Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
- Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements
- Frequent use of vision and depth perception for near and far distances and to identify and distinguish colors
- Frequent use of hearing and speech to share information through oral communication
- Occasional bending, stooping, kneeling, squatting, twisting and gripping
- Rare climbing
- No professional license or certification required
Benefits:
- Equal employment opportunities without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law
Similar Jobs
Referral Coordinator – Continence Care
Referral Coordinator processing healthcare referrals and insurance verification for Comfort Medical’s catheter and ostomy supplies. Maintaining medical records, customer accounts, and order documentation.
Authorization and Referral Coordinator
Dental authorization coordinator managing insurance verification, treatment estimates, referrals, and prior authorizations for Missouri patients. Supporting dental teams and patients with coverage communication, documentation, and care coordination.
Medical Records, Referral Coordinator
Medical Records & Referral Coordinator at Herself Health managing workflows for patient records and referrals. Ensuring compliance and continuity of care for women’s primary health services.
Referral Coordinator
Referral Coordinator at InnovaCare managing referrals, patient registration, and insurance authorization. Ensuring patient safety and effective communication with referral sources in health care settings.
No more related jobs available.