Referral Coordinator I
Referral Coordinator I
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Job Description
Its more than a career its a calling.
ILSSM Health St. Marys Hospital CentraliaWorker Type:
RegularJob Highlights:
Schedule: Fulltime Day shift Mon Fri 8:00am 4:30pm
Pay Range:
$15.00 $22.15Pay Rate Type:
HourlySSM Health values the skills and talents that each team member brings to our organization. Compensation for this role is based on a variety of components including relevant experience labor market and other qualifications. The posted pay range for this position is what SSM Health reasonably expects in good faith to offer based on the circumstances at the time of posting. SSM Health may ultimately pay more or less than the posted range as permitted by law.Job Summary:
Coordinates provider referrals precertifications and preauthorizations for managed care insurance plans.Job Responsibilities and Requirements:
PRIMARY RESPONSIBILITIES
- Attends inservices provided by various health plans.
- Travels to offsite locations as necessary.
- Gathers necessary clinical information and processes referrals precertification predeterminations and preauthorizes 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 preauthorizations.
- Verifies insurance coverage benefits and creatrs price estimates reverifications as needed (ex; first of the month reverifications for managed Medicaids).
- Works collaboratively with insurance companies providers and staff to ensure plan requirements have been met prior to patient services being rendered in order to maximize reimbursement.
- Performs all other duties as assigned.
EDUCATION
- High School diploma/GED or 10 years of work experience
EXPERIENCE
- No experience required
PHYSICAL REQUIREMENTS
- Frequent lifting/carrying and pushing/pulling objects weighing 025 lbs.
- Frequent sitting standing walking reaching and repetitive foot/leg and hand/arm movements.
- Frequent use of vision and depth perception for distances near 20 inches or less) and far 20 feet or more) and to identify and distinguish colors.
- Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms malfunctioning machinery etc.
- Frequent keyboard use/data entry.
- Occasional bending stooping kneeling squatting twisting and gripping.
- Occasional lifting/carrying and pushing/pulling objects weighing 2550 lbs.
- Rare climbing.
REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS
- None
Department:
Centralia PodiatryWork Shift:
Day Shift (United States of America)Scheduled Weekly Hours:
40Benefits:
SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.
Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (prorated based on FTE).
Flexible Payment Options:our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned unpaid base pay(fees may apply)before payday.
Upfront Tuition Coverage:we provide upfront tuition coverage through FlexPath Funded for eligible team members.
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. Click here to learn more.
Required Experience:
IC
Employment Type
Full-Time
