Referral Coordinator

• 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