Referral Coordinator II

Job description

It's more than a career, it's a calling. MO-SSM Health St. Lukes Medical Building South Worker Type: Regular Job Highlights: The Referral Coordinator II plays a vital role in supporting patient access and care coordination within a busy Cardiology specialty practice. This on-site position is scheduled Monday through Friday from 8:00 AM to 4:30 PM, offering a consistent weekday schedule with no weekends or holidays required. 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 procedural changes for pre-authorizations. - Verifies insurance coverage, benefits and creatrs price estimates, reverifications as needed...