Referral Coordinator - Part Time Oncology Network

SSM Health • Jefferson City, MO

20h • Remote

About The Position

It's more than a career, it's a calling.
MO-REMOTE
Worker Type:
Regular
Job Highlights:
Part-time position with flexible schedule
Role is 24 hours per week
Note that there is a probationary period in which during orientation and training this position would be on site; after that is completed successfully, the position would become remote eligible
Job Summary:
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 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.
• Performs all other duties as assigned.

Benefits

• SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.
• Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
• Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.
• Explore All Benefits
• SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED