Referral Coordinator II

Job Opportunity At SSM Health Cardinal Glennon Children's Hospital It's more than a career, it's a calling. MO-SSM Health Cardinal Glennon Children's Hospital Worker Type: Regular Job Highlights: The position is hybrid upon completion of the Training requirements (On-site). Monday-Friday-8:00AM-4:30PM Minimum one year experience is required Preferred experience in pre-certification and Excel Location-SSM Health Cardinal Glennon's Children's Hospital Job Summary Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. Job Responsibilities and Requirements Attends in-services provided by various health plans. Travels to off-site locations as necessary. Gathers necessary clinical information and processes referrals, pre-certification, pre-determinations, and pre-authorizes according to insurance plan requirements. Logs, tracks and reviews managed care approvals and denials. Responds in a timely manner to last minute/emergency referrals or additional codes performed during a procedure, or procedural changes for pre-authorizations. Verifies insurance coverage, benefits and creates price estimates, reverifications as needed (ex; first of the month reverifications for managed Medicaid's). 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. Preregisters patients for appointments. Schedules patients for appointments appropriately. Performs all other duties as assigned. Education High School diploma/GED or 10 years of work experience Experience One year experience required 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. 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. Required Professional License and/or Certifications None Work Shift Day Shift (United States of America) Scheduled Weekly Hours 40 Benefits SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. 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.

Created: 2026-03-04