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
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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