Referral Coordinator II

It's more than a career, it's a calling. OK-SSM Health Medical Group Oklahoma City 6201 Worker Type: Regular Job Highlights: Department: Physical Therapy Schedule: Full time days (Day Shift) Location: North OKC Our mission and values put the patient first and help you 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. At SSM Health, we know the healing power of presence begins with compassionate people like you. 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‑authorizations according to insurance plan requirements. Logs, tracks, and reviews managed‑care approvals and denials. Responds in a timely manner to last‑minute or emergency referrals or additional codes performed during a procedure, or procedural changes for pre‑authorizations. Verifies insurance coverage, benefits and creates price estimates, reverifies as needed (ex: first of the month reverifications for managed Medicaid). 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. Pre‑registers patients for appointments. Schedules patients for appointments appropriately. Performs all other duties as assigned. Education and Experience High School diploma or GED, or 10 years of work experience. One year of experience required. Professional Licenses and Certifications None required. Physical Requirements Frequent lifting/carrying and pushing/pulling objects weighing 0 to 25 lbs. Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements. Frequent use of vision and depth perception for near (20 inches or less) and far (20 feet or more) distances, and to identify and distinguish colors. Frequent use of hearing and speech to share information through oral communication, and to hear alarms and malfunctioning machinery. Frequent keyboard use and data entry. Occasional bending, stooping, kneeling, squatting, twisting and gripping. Occasional lifting/carrying and pushing/pulling objects weighing 25 to 50 lbs. Rare climbing. Benefits Paid Parental Leave: one week of paid parental leave for newborns or newly adopted children (pro‑rated based on FTE). Flexible Payment Options: voluntary benefit offered through DailyPay providing eligible hourly team members instant access to earned, unpaid base pay before payday (fees may apply). Upfront Tuition Coverage: upfront tuition coverage through FlexPath Funded for eligible team members. Daily Pay: get paid daily. EEO Statement 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. #J-18808-Ljbffr