Referral Coordinator I
SSM Health · St. Louis, Missouri, US
It's more than a career, it's a calling. MO-SSM Health Medical Group St. Charles-1821 Sherman Drive Worker Type: Regular Job Highlights: Monday-Friday-8:00AM...
Job description
It's more than a career, it's a calling. MO-SSM Health Medical Group St. Charles-1821 Sherman Drive Worker Type: Regular Job Highlights: Monday-Friday-8:00AM-4:30PM Healthcare experience preferred: Patient oriented individual: Location-SSM Health-Medical Group-St. Charles: Join Our Team and make a difference every day while enjoying competitive pay, great benefits, and a supportive work environment. We offer competitive, affordable health insurance and benefits designed to support you and your family Fulfill your calling with SSM Health — apply today! Job Summary: Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES - Attends in-services provided by various health plans. - Travels to off-site locations as necessary. - Gathers necessary clinical information and processes referrals, pre-certification, pre-determinations, and pre-authorizes according to insurance plan requirements. - Logs, tracks and reviews managed care approvals and denials. - Responds in a timely manner to last minute/emergency referrals or additional codes performed during a procedure, or procedu...