Sleep Lab Referral & Authorization Coordinator | Daily Pay

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

Job summary

SSM Health St. Mary's Hospital – Jefferson City is seeking a Regular full-time Referral Coordinator in the Sleep Disorders Lab.

You will coordinate provider referrals, pre-certifications, and pre-authorizations for managed care plans, while traveling to off-site locations as needed and ensuring timely, accurate communication with plans and providers. Responsibilities include logging and tracking approvals/denials, handling emergency referrals, verifying insurance benefits, preregistering and

Qualifications

• High School diploma/GED or 10 years of work experience.
• One year experience required.

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

Job description

SSM Health St. Mary's Hospital – Jefferson City is seeking a Regular full-time Referral Coordinator in the Sleep Disorders Lab.

You will coordinate provider referrals, pre-certifications, and pre-authorizations for managed care plans, while traveling to off-site locations as needed and ensuring timely, accurate communication with plans and providers. Responsibilities include logging and tracking approvals/denials, handling emergency referrals, verifying insurance benefits, preregistering and