Referral Coordinator

SSM Health

. Attend in-services provided by various health plans .

Posted 9/19/2026full-timeRemote • Missouri • United StatesSeniorLeadWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates proficiency in processing referrals, pre-authorizations, and verifying insurance coverage while collaborating effectively with insurance companies and healthcare providers to ensure compliance with plan requirements.

Highest-signal resume keywords

Referral ProcessingInsurance VerificationManaged Care ApprovalsData EntryCollaboration with Providers

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Referral ProcessingPre-AuthorizationInsurance VerificationData EntryPrice Estimation

Soft Skills

Oral CommunicationCollaboration

Industry Keywords

Managed CarePre-CertificationPre-DeterminationEmergency ReferralsMedicaid Plans

About the role

Key responsibilities & impact

Attend in-services provided by various health plans
Travel to off-site locations as necessary
Gather clinical information and process referrals, pre-certifications, pre-determinations, and pre-authorizations according to insurance plan requirements
Log, track, and review managed care approvals and denials
Respond to last-minute or emergency referrals, additional procedure codes, and procedural changes for pre-authorizations
Verify insurance coverage and benefits
Create price estimates and perform reverifications as needed, including first-of-the-month reverifications for managed Medicaid plans
Collaborate with insurance companies, providers, and staff to ensure plan requirements are met before patient services are rendered and maximize reimbursement
Perform other duties as assigned

Requirements

What you’ll need

High School diploma/GED or 10 years of work experience
No experience required
Must reside within one hour of the location
Frequent keyboard use/data entry
Ability to hear alarms, malfunctioning machinery, etc.
Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements
Frequent use of vision and depth perception for near and far distances and to identify and distinguish colors
Frequent use of hearing and speech to share information through oral communication
Occasional bending, stooping, kneeling, squatting, twisting and gripping
Rare climbing
No professional license or certification required

Benefits

Comp & perks

Equal employment opportunities without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law