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SSM Health
Overview
The Referral Coordinator II is responsible for coordinating provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. This includes gathering clinical information, processing referrals, and ensuring compliance with insurance plan requirements.
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Compensation
Salary not listed
Posted
3 days ago
Washington University in St. Louis
Coordinates pre-certification and benefit verification for medical and surgical procedures to maximize reimbursement. Manages the department faculty's surgery schedule and maintains detailed logs of all pre-certification processes.
$21 - $31 / HOUR
15 days ago
The Pre-Certification Coordinator I initiates and facilitates the pre-determination process for insurance pre-certifications. They maintain communication with physicians and manage the surgery/procedure schedule for the department.
16 days ago
WVU Medicine
The Registration Specialist performs administrative and clerical duties related to patient registration and financial obligations. This includes obtaining and entering patient information, collecting payments, and ensuring compliance with hospital procedures.
23 days ago
Acadia
The Utilization Specialist will monitor service utilization for patients to optimize reimbursement and act as a liaison between managed care organizations and clinical staff. They will conduct reviews, gather statistical information, and facilitate peer review calls.
24 days ago
The Registration Specialist performs administrative and clerical duties related to patient registration and financial obligations. This includes obtaining patient information, processing payments, and ensuring compliance with hospital procedures.
26 days ago
REGIONAL ONE HEALTH
Responsible for obtaining precertification for procedures and testing while validating insurance eligibility. The role involves communicating policies to patients and medical staff and maintaining accurate clinical documentation.
1 month ago
Baptist
The Authorization Denial Specialist ensures that chemotherapy and other services meet medical necessity according to insurance policies and guidelines. They initiate pre-certifications and coordinate authorizations while reviewing clinical information to address authorization denials.
2 months ago
Northside Hospital Inc.
The primary responsibility is to verify patient insurance and initiate the pre-certification process for patient visits. This role supports administrative functions within the healthcare practice.
Davies
The role involves independently managing medical claims for injured workers in a Workers' Compensation environment, focusing on coordinating care to ensure quality medical outcomes and timely, cost-effective return-to-work.
$75,000 - $83,000 / YEAR
3 months ago
Surgery Partners, Inc
This role involves performing various business office activities including admissions, scheduling, billing, insurance verification, and medical records management, while maintaining a professional presence to direct inquiries appropriately. Key duties include admitting patients, handling financial collections like co-payments, and accurately maintaining schedules based on staff availability and patient needs.
Cardiology Consultants of Philadelphia
The Precertification Specialist is responsible for obtaining prior authorization or precertification for all testing procedures performed in the office, including various cardiology tests like Echocardiograms and Nuclear stress tests. This must be done in a timely fashion, ensuring authorization is secured one week prior for scheduled testing and for all add-on or same-day procedures.
DAYMARK RECOVERY SERVICES INC
The Utilization Review Coordinator initiates pre-certification calls for insurance plans and conducts concurrent reviews during patient stays. They also manage the insurance appeal process and communicate treatment team recommendations.
$18 - $23 / HOUR
5 months ago
