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Washington University in St. Louis

Located in St. Louis, Missouri, Washington University in St. Louis is an award-winning institution of higher education dedicated to excellence in learning, teac

Pre - Certification Coordinator II

Location

United States

Posted

7 days ago

Salary

$22 - $34 / hour

Seniority

Senior

High School3 yrs expEnglish

Job Description

Pre - Certification Coordinator II

Washington University in St. Louis

• Completes pre-certifications for complex and specialized services as indicated on therapy and treatment plans • Reads and analyzes therapy and treatment plans, drug protocols, and clinical documentation, as well as payer policies and patient benefits • Completes the authorization process with the payer and in EPIC • Completes rechecks on existing pre-certifications by verifying insurance eligibility and all authorization information for all applicable services • Confirms all recheck information is documented in EPIC • Works with clinical staff and providers on add-ons, denials and peer to peers through to resolution • Performs other duties as assigned, such as assistance with denials, rejections and appeals

Job Requirements

  • High school diploma or equivalent high school certification or combination of education and/or experience
  • 3 years experience in Clinical Office, Medical Billing, Health Information Management (HIM), or Pre-Certification
  • Communication skills
  • Detail-Oriented
  • Experience with Epic EHR
  • Knowledge of Health Insurance Portability & Accountability Act (HIPAA)
  • Familiarity with Insurance Claim Processing Software
  • Understanding of Insurance Precertification and Insurance Terminology

Benefits

  • Up to 22 days of vacation
  • 10 recognized holidays
  • Sick time
  • Competitive health insurance packages with priority appointments and lower copays/coinsurance
  • Free Metro transit U-Pass for eligible employees
  • Defined contribution (403(b)) Retirement Savings Plan
  • Wellness challenges
  • Annual health screenings
  • Mental health resources
  • Mindfulness programs and courses
  • Employee assistance program (EAP)
  • Financial resources
  • Access to dietitians
  • 4 weeks of caregiver leave to bond with your new child
  • Family care resources for continued childcare needs
  • Tuition coverage for you and your family

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