Referral Coordinator II - SSM Health : Job Details

**It's more than a career, it's a calling.**OK-SSM Health Medical Group Shawnee Kethley 3315**Worker Type:**Regular**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 (ex; first of the month reverifications for managed Medicaid's).+ 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.+ Preregisters patients for appointments.+ Schedules patients for appointments appropriately.+ Performs all other duties as assigned.EDUCATION+ High School diploma/GED or 10 years of work experienceEXPERIENCE+ One year experience requiredPHYSICAL REQUIREMENTS+ Frequent lifting/carrying and pushing/pulling objects weighing 0-25 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 25-50 lbs.+ Rare climbing.REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS+ None**Work Shift:**Day Shift (United States of America)**Job Type:**Employee**Department:**655####### SPS DERM**Scheduled Weekly Hours:**40**Benefits:**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 (pro-rated 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.Explore All Benefits ( 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. (