Referral Coordinator - Orthopedics

SSM Health Care • Oklahoma City, OK

90d • $16

About The Position

It's more than a career, it's a calling. At SSM Health St. Anthony Hospital, we put the patient first and help you to feel valued while respecting teamwork and collaboration. Our Referral Coordinator roles are an integral piece in our care team and we see it as a partnership. We know the healing power of presence begins with compassionate people like you. This position coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans.

Requirements

• High School diploma/GED or 10 years of work experience.
• No 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 creates price estimates, reverifications as needed.
• 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.
• Performs all other duties as assigned.

Benefits

• Paid Parental Leave: one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: instant access to earned, unpaid base pay before payday through DailyPay.
• Upfront Tuition Coverage: upfront tuition coverage through FlexPath Funded for eligible team members.

What This Job Offers

• Job Type: Full-time
• Industry: Hospitals
• Education Level: High school or GED