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MO-SSM Health SLUCare Center for Specialized Medicine

Worker Type:

Regular

Job Summary:

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

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Attends in-services provided by various health plans and conveys changes in insurance plan requirements to appropriate staff.
• Maintains and provides training materials and education regarding insurance plans to staff.
• Travels to off-site locations as necessary.
• Provides support to the staff in the supervisor's absence.
• Assists supervisors in reviewing and reporting metrics.
• 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 to the system.
• Performs all other duties as assigned.

EDUCATION

• High school diploma or equivalent

EXPERIENCE

• Three years' experience

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.

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REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

• None

Work Shift:

Day Shift (United States of America)

Employee

Department:

4932200235 SLUCR NEUR CSM 1L

Scheduled Weekly Hours:

40

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.