Referral Coordinator II - PRN - Cancer Care

Overview

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Referral Coordinator II - PRN - Cancer Care

role at

SSM Health
MO-REMOTE
Worker Type: PRN
Job Highlights

This is a PRN (as needed) position filling in open shifts during the week. The hours would be 7:30am-4pm and will support all 6 Care Care Infusion Centers. The position will be remote after training period. There are no guaranteed hours or benefits.
Job Summary

Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans.
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 Medicaids).
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
Experience

One year experience required
Physical Requirements

Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
Frequent keyboard use/data entry.
Occasional bending, stooping, kneeling, squatting, twisting and gripping.
Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
Rare climbing.
Required Professional License And/Or Certifications

None
Department

6888000125 Oncology Network
Work Shift

Day Shift (United States of America)
Scheduled Weekly Hours

0
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.
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.
Seniority level

Entry level
Employment type

Part-time
Job function

Health Care Provider
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