Referral & Authorization Specialist (Day Shift)

SSM Health; St. Louis (MO); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Paid Parental Leave

Flexible Payment Options (DailyPay)

Upfront Tuition Coverage

Job summary

SSM Health DePaul Hospital - St. Louis is seeking a Referral Coordinator to manage provider referrals, pre-certifications, and pre-authorizations for managed care plans.

This full-time, day-shift role requires EPIC experience, strong customer service skills, and the ability to travel to off-site locations when needed. You will preregister and schedule patients and support planned care workflows.

Qualifications

• High School diploma or GED required, or 10 years of related work experience.
• Minimum 1 year of experience in a similar role.
• EPIC experience and referrals/authorizations experience preferred.
• Strong customer service skills required.

Responsibilities

• Attends in-services provided by health plans.
• Travels to off-site locations as necessary.
• Gathers clinical information and processes referrals, pre-certification, pre-determinations, and pre-authorizations per plan rules.
• Logs, tracks and reviews managed care approvals and denials.
• Responds promptly to last-minute referrals or changes for pre-authorizations.
• Verifies insurance coverage and benefits; supports pricing estimates as needed.
• Preregister and schedule patients for appointments; perform other duties as assigned.

Skills

Customer service

Education

High School diploma/GED

10 years of work experience

1 year of experience in related role

Tools

EPIC software

Job description

SSM Health DePaul Hospital - St. Louis is seeking a Referral Coordinator to manage provider referrals, pre-certifications, and pre-authorizations for managed care plans.

This full-time, day-shift role requires EPIC experience, strong customer service skills, and the ability to travel to off-site locations when needed. You will preregister and schedule patients and support planned care workflows.