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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

Lead Pre-Certification Coordinator – Department of Medicine

Location

United States

Posted

7 days ago

Salary

$22 - $34 / hour

Seniority

Senior

High School3 yrs expEnglish

Job Description

Lead Pre-Certification Coordinator – Department of Medicine

Washington University in St. Louis

• Leads the pre-certification section in daily activities and prioritization of assignments • Assists in adjusting daily assignments based on coverage needs of the team and unit • Answers the pre-certification phone lines; assists with billing inquiries, insurance questions, and missing order and pre-certification issues • Acts as liaison between department facilities and physician offices • Contacts appropriate insurance companies for benefit verification and pre-certification of procedures and testing • Supplies all documentation required during pre-certification process to insurance companies • Documents when pre-certification is received from insurance companies and maintains open communication with physicians and their assistants regarding concerns or when physician involvement is needed • Provides training and education to staff • Assists staff with complex cases avoiding denials and physician peer to pears • Reviews denials to see if there is a potential for re-consideration • Provides feedback to management regarding staffing concerns and process improvement

Job Requirements

  • High school diploma or equivalent high school certification or combination of education and/or experience
  • Medical Billing/Coding (3 Years)
  • Previous pre-certification experience
  • Some college or an associate’s degree preferred
  • Coding experience preferred
  • Thorough understanding of Washington University FSC database and insurance terminology
  • Experience interacting with managed care plans, insurance companies, and third-party payers
  • Ability to work with internal and external customers, including physicians, nurses, patients, and families
  • Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT) preferred

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 with university contributions starting at 7%
  • 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 new child
  • Family care resources for continued childcare needs
  • Tuition coverage for employees and family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us

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