Pre-Certification Coordinator II (Remote) - Department of Medicine - Business Office

Requirements

• Not Applicable
• Driver's License:
• A driver's license is not required for this position.
• More About This Job
• WashU seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles.
• Education:
• Associate degree
• Certifications /Professional Licenses :
• Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)
• Work Experience:
• No additional work experience unless stated elsewhere in the job posting.
• Grade
• C09-H
• Salary Range
• $22.78 - $34.21 / Hourly
• Questions
• For frequently asked questions about the application process, please refer to our External Applicant FAQ .
• Accommodation
• If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.
• All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.
• Pre-Employment Screening
• Benefits Statement
• Personal
• Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Take advantage of our free Me

Benefits

Additional Information

Scheduled Hours 40 Position Summary Advanced level specialization in complex pre-certifications as indicated on therapy and treatment plans to prevent controllable losses/write offs for the Department. May perform re-checks of insurance eligibility and verify authorization information for each service. Documents all pertinent authorization information in EPIC and communicates with clinical staff and providers in a timely and effective manner. Job Description Primary Duties & Responsibilities: 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 in a timely fashion. Performs other duties as assigned, such as assistance with denials, rejections and appeals. Working Conditions: Job Location/Working Conditions: Normal office environment. Physical Effort: Typically sitting at desk or table. Equipment: Office equipment. The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time. Required Qualifications Education: High school diploma or equivalent high school certification or combination of education and/or experience. Certifications /Professional Licenses : No specific certification/professional license is required for this position. Work Experience: Clinical Office, Medical Billing, Health Information Management (Him), Or Pre-Certification (3 Years)

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