It's more than a career, it's a calling. IL-SSM Health St. Mary's Hospital - Centralia Worker Type: Regular Job Highlights: Job Highlights (Additional Job Description) Department: Physical Medicine Patient Population or Ratio: N/A Schedule: Full Time, Day Shift, 32 hrs per week minimum; start and end times are variable between 7am-5pm Starting Pay: 15.80 (Offers are based on years of experience and equity for this role.) Shift Differentials: N/A Location: SSM Health – Good Samaritan Hospital 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 or equivalent EXPERIENCE One year experience required PHYSICAL 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 Department: 4509000207 Rehab Administration Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 32 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. Create or login to your SSM Health Candidate Workday account to track your application progress and see real-time updates. Remember to keep a record of your login information to access your Candidate Workday account in the future! Current Employees & Contractors – please apply internally via the Career app on your Workday home page. Do not continue here. Visit here for more information.