SSM Health
SSM Health
SSM Health is a Catholic, not-for-profit healthcare system supporting communities across the U.S. Midwest. Its integrated network spans hospitals, clinics, and other care services in Illinois, Missouri, Oklahoma, and Wisconsin, including teaching hospitals, acute-care facilities, specialty programs, and level-one trauma centers. The organization combines mission-driven patient care with workforce development and hires for nursing and other clinical roles, including flexible opportunities where available.

Referral Coordinator - Missouri Remote

Coordinate SSM Health patient referrals, pre-certifications, and insurance authorizations for timely care. Verify coverage and work with providers to meet plan requirements.

Description

  • Participate in health plan in-service training.
  • Travel to off-site locations when required.
  • Collect clinical information and process referrals, pre-certifications, pre-determinations, and pre-authorizations in line with insurance plan requirements.
  • Record, monitor, and review managed care approvals and denials.
  • Handle urgent or last-minute referrals, additional procedure codes, and procedural changes affecting pre-authorizations.
  • Confirm insurance coverage and benefits.
  • Prepare patient price estimates and complete reverifications as needed, including monthly reverifications for managed Medicaid plans.
  • Coordinate with insurers, providers, and staff to satisfy plan requirements before services are delivered and support maximum reimbursement.
  • Complete other assigned duties.

Requirements

  • High school diploma or GED, or 10 years of work experience.
  • Previous experience is not required.
  • Must live within one hour of the designated location.
  • Frequent keyboarding and data entry are required.
  • Ability to hear alarms, malfunctioning machinery, and similar signals.
  • Frequently lift, carry, push, or pull objects weighing up to 25 pounds.
  • Occasionally lift, carry, push, or pull objects weighing 25 to 50 pounds.
  • Frequently sit, stand, walk, reach, and perform repetitive foot, leg, hand, and arm movements.
  • Frequently use near and far vision and depth perception to identify and distinguish colors.
  • Frequently use hearing and speech for verbal communication.
  • Occasionally bend, stoop, kneel, squat, twist, and grip.
  • Rarely climb.
  • No professional license or certification is required.

Benefits

  • SSM Health provides equal employment opportunities regardless of race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law.

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