Day-Shift Referral & Authorization Specialist

SSM Health; Bridgeton (MO); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Paid Parental Leave

Flexible Payment Options

Upfront Tuition Coverage

Job summary

SSM Health DePaul Hospital – St. Louis is seeking a dedicated coordinator to manage referrals, pre-certifications, and pre-authorizations for managed care plans.

The role requires EPIC experience and strong customer service skills, with regular day shifts and a full-time schedule. Primary duties include coordinating patient referrals, gathering necessary information, and ensuring plan requirements are met prior to service delivery.

Qualifications

• EPIC experience preferred in health plan workflows.
• Experience with referrals and authorizations is highly preferred.
• Must have good customer service skills.

Responsibilities

• Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care plans.
• Gathers necessary clinical information and processes referrals and pre-authorizations according to plan requirements.
• Logs, tracks and reviews managed care approvals and denials to maximize reimbursement.
• Preregisters patients and schedules appointments as needed.
• Travels to off-site locations as necessary.

Skills

Customer service

Referral management

Pre-authorizations

Education

High School diploma/GED or 10 years of work experience

Tools

EPIC

Job description

SSM Health DePaul Hospital – St. Louis is seeking a dedicated coordinator to manage referrals, pre-certifications, and pre-authorizations for managed care plans.

The role requires EPIC experience and strong customer service skills, with regular day shifts and a full-time schedule. Primary duties include coordinating patient referrals, gathering necessary information, and ensuring plan requirements are met prior to service delivery.