Pre-Certification Coordinator II – Business Office – Medicine

Scheduled Hours
40

Place Abstract
This superior degree Pre-certification Coordinator makes a speciality of complicated pre-certifications for top greenback oncology and/or non-oncology medication as indicated on remedy and remedy plans to forestall controllable losses/write offs for the Division. This place may carry out rechecks of insurance coverage eligibility and confirm authorization info for every service. This place will even doc all pertinent authorization info in Epic and talk with scientific employees and suppliers in a well timed and efficient method.

Job Description

Main Duties & Tasks

• Completes pre-certifications for complicated and excessive greenback medication as indicated on remedy and remedy plans. Should learn and analyze remedy and remedy plans, drug protocols and scientific documentation, in addition to payer insurance policies and affected person advantages. Completes the authorization course of with the payer and in EPIC.
• Completes rechecks on present pre-certifications by verifying insurance coverage eligibility and all authorization info for all relevant providers. Confirms all recheck info is documented in EPIC.
• Works with scientific employees and suppliers on add-ons, denials and peer to friends by to decision in a well timed vogue.
• Different duties as assigned, comparable to help with denials, rejections and appeals.

Most well-liked {Qualifications}

• Some faculty or affiliate’s diploma; RHIT and/or CPC certification; coding expertise and former precertification expertise.
• Thorough understanding of each Washington College insurance coverage database and insurance coverage terminology.
• Glorious communication, interpersonal and organizational abilities requires; expertise interacting with managed care plans, insurance coverage corporations and third-party payers.
• Capacity to work with inside and exterior clients, together with physicians, nurses, sufferers and households.
• Capacity to prioritize a number of duties, be very particulars oriented and in a position to work in a quick paced atmosphere.

Required {Qualifications}

• Highschool diploma or equal highschool certification.
• Three to 5 years of expertise in medical billing/coding.

Grade
C09-H

Wage Vary
$22.33 – $33.53 / Hourly

The wage vary displays base salaries paid for positions in a given job grade throughout the College. Particular person charges inside the vary will probably be decided by components together with one’s {qualifications} and efficiency, fairness with others within the division, market charges for positions inside the identical grade and division finances.

Lodging

If you’re unable to make use of our on-line software system and would love an lodging, please e-mail [email protected]  or name the devoted lodging inquiry quantity at 314-935-1149 and go away a voicemail with the character of your request.

Pre-Employment Screening
All exterior candidates receiving a suggestion for employment will probably be required to undergo pre-employment screening for this place. The screenings will embrace prison background verify and, as relevant for the place, different background checks, drug display, an employment and schooling or licensure/certification verification, bodily examination, sure vaccinations and/or governmental registry checks. All affords are contingent upon profitable completion of required screening.

Advantages Assertion

Private

• As much as 22 days of trip, 10 acknowledged holidays, and sick time.

• Aggressive medical health insurance packages with precedence appointments and decrease copays/coinsurance.

• Wish to Reside Close to Your Work and/or enhance your commute? Make the most of our free Metro transit U-Cross for eligible workers. We additionally supply a forgivable residence mortgage of as much as $12,500 for closing prices and a down cost for properties in eligible neighborhoods.

• WashU offers eligible workers with an outlined contribution (403(b)) Retirement Financial savings Plan, which mixes worker contributions and college contributions beginning at 7%.

Wellness

• Wellness challenges, annual well being screenings, psychological well being assets, mindfulness applications and programs, worker help program (EAP), monetary assets, entry to dietitians, and extra!

Household

• We provide 4 weeks of caregiver go away to bond together with your new youngster. Household care assets are additionally out there to your continued childcare wants. Want grownup care? We’ve bought you coated.

• WashU covers the price of tuition for you and your loved ones, together with dependent undergraduate-level faculty tuition as much as 100% at WashU and 40% elsewhere after seven years with us.

For insurance policies, detailed advantages, and eligibility, please go to: https://hr.wustl.edu/advantages/

EEO/AA Assertion
Washington College in St. Louis is dedicated to the rules and practices of equal employment alternative and particularly encourages purposes by these from underrepresented teams. It’s the College’s coverage to supply equal alternative and entry to individuals in all job titles with out regard to race, ethnicity, shade, nationwide origin, age, faith, intercourse, sexual orientation, gender identification or expression, incapacity, protected veteran standing, or genetic info.

Range Assertion
Washington College is devoted to constructing a various neighborhood of people who’re dedicated to contributing to an inclusive atmosphere – fostering respect for all and welcoming people from numerous backgrounds, experiences and views. People with a dedication to those values are inspired to use.