Remotehey

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for SSM Health. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice.

It's more than a career, it's a calling.

OK-REMOTE

Worker Type

Regular

Job Highlights

• Department: Centralized Scheduling
• Schedule: Full Time, Days
• Live in OK preferred
• Location: OKC
  
  

Our mission and values put the patient first and helps you to 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.

Daily Pay : Get paid daily doing the work you love in a way that fits your life. At SSM Health, we believe you deserve the flexibility to work a schedule that fits your life and to get paid when you need it.

Job Summary

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

Primary Responsibilities

Job Responsibilities and Requirements:

• 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.
• 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

8073000040 Centralized Scheduling

Work Shift

Day Shift (United States of America)

Scheduled Weekly Hours

40

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 (https://jobs.ssmhealth.com/us/en/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. (https://www.ssmhealth.com/privacy-notices-terms-of-use/non-discrimination?_ga=2.205881493.704955970.1667719643-240470506.1667719643)

If you have questions about this posting, please contact [email protected]