Referral Coordinator
RemoteMissouri, United States
Job Summary
Coordinate provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans by attending in-services, gathering clinical information, and processing approvals according to plan requirements. Log, track, and review managed care approvals and denials while responding timely to emergency referrals or procedural changes. Verify insurance coverage, benefits, and create price estimates, including reverifications as needed. Collaborate with insurance companies, providers, and staff to ensure plan requirements are met prior to patient services to maximize reimbursement. Requires Microsoft Office skills, customer service experience, and healthcare terminology knowledge. Full-time day shift Monday through Friday with hybrid work options.
Required Qualifications
- Microsoft office
- customers skills
- prior knowledge in healthcare terminology
- High School diploma/GED or 10 years of work experience
- 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
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