Day-Shift Referral & Pre-Auth Coordinator

SSM Health; Missouri; On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Paid parental leave

DailyPay flexible payment options

Tuition coverage via FlexPath

Job summary

SSM Health is seeking a Referral Coordinator to manage provider referrals, pre-certifications, and pre-authorizations for managed care plans. This full-time, day-shift role involves coordinating with health plans, providers, and staff to ensure timely and accurate pre-authorization processes.

Qualifications include a High School diploma or GED and at least one year of referral coordination experience. Occasional travel to off-site locations may be required.

Qualifications

• High School diploma or GED or equivalent work experience.
• One year of experience in referral coordination or related role.
• Ability to travel to off-site locations.
• Excellent communication and organizational skills.
• Experience with managed care or insurance processes is a plus.

Responsibilities

• Attends in-services provided by various health plans.
• Travels to off-site locations as necessary.
• Gathers clinical information and processes referrals, pre-certifications, and pre-authorizations.
• Logs, tracks and reviews managed care approvals and denials.
• Responds promptly to urgent referrals or changes for pre-authorizations.
• Verifies coverage and benefits and creates price estimates; reverifications as needed.
• Coordinates with insurers, providers and staff to meet plan requirements before services.
• Preregisters patients for appointments.
• Schedules patients for appointments appropriately.
• Performs all other duties as assigned.

Skills

Referral coordination

Pre-authorizations

Managed care

Insurance billing

Education

High School diploma/GED

Job description

SSM Health is seeking a Referral Coordinator to manage provider referrals, pre-certifications, and pre-authorizations for managed care plans. This full-time, day-shift role involves coordinating with health plans, providers, and staff to ensure timely and accurate pre-authorization processes.

Qualifications include a High School diploma or GED and at least one year of referral coordination experience. Occasional travel to off-site locations may be required.