Referral Coord - Physical Therapy

It's more than a career, it's a calling. OK-SSM Health Medical Group Oklahoma City 6201 Worker Type: Regular Job Summary Coordinates provider referrals, pre‑certifications, and pre‑authorizations for managed care insurance plans. Primary 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/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 (e.g., 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. Pre‑registers 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. 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 provides 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. SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. 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. #J-18808-Ljbffr SSM Health