What are the responsibilities and job description for the Referral Coordinator II position at SSM Health Care Group?
It's more than a career, it's a calling. IL-REMOTE STL PLAN Worker Type: Regular Job Highlights: Monday thru Friday 8:00AM-4:30PM One year experience is required Prior Authorization and referral experience preferred Medical Terminology preferred Candidate has to reside in the state MO Flexibility to come to the office as needed for Meeting and or training Pay Range: $17.23 - $25.85 Pay Rate Type: Hourly SSM 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, 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 experience 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: 8565000235 SLUCare Centralized Contact Ctr Work Shift: Day Shift (United States of America) 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 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.
Salary : $17 - $26