Pre-Certification Coordinator II – Department of Medicine

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WashU IT

WebsiteLinkedInAll Job Openings

501 - 1000 employees

📚 Education

🏢 Enterprise

☁️ SaaS

Education • Enterprise • SaaS

WashU IT is the information technology department of Washington University in St. Louis, providing essential IT services and support for the university's students, faculty, and staff. The department is integral to facilitating the university’s academic, research, and administrative functions, ensuring that technological resources and solutions are efficiently delivered and maintained across the university’s campuses. WashU IT also plays a crucial role in helping the university confront complex technological challenges and enhance its operational capabilities.

📋 Description

• 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 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, including assistance with denials, rejections, and appeals

🎯 Requirements

• High school diploma or equivalent certification or combination of education and/or experience • 3 years of experience in Clinical Office, Medical Billing, Health Information Management (Him), or Pre-Certification • No specific certification/professional license is required for this position • Skills: Not Applicable

🏖️ 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 starting at 7% • Wellness challenges, annual health screenings, mental health resources, mindfulness programs, employee assistance program (EAP), financial resources, access to dietitians • 4 weeks of caregiver leave to bond with your new child • WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.