Pre-Certification Coordinator II

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🔥 7 hours ago

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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

• Complete pre-certifications for complex and specialized services based on therapy and treatment plans • Read and analyze therapy and treatment plans, drug protocols, clinical documentation, payer policies, and patient benefits • Complete authorization processes with payers and document authorization information in EPIC • Recheck existing pre-certifications by verifying insurance eligibility and authorization information • Document recheck information in EPIC • Work with clinical staff and providers on add-ons, denials, and peer-to-peer reviews through resolution • Assist with denials, rejections, and appeals • Perform other duties as assigned

🎯 Requirements

• High school diploma or equivalent high school certification, or combination of education and/or experience • 3 years of experience in clinical office, medical billing, health information management (HIM), or pre-certification • Ability to read and analyze therapy and treatment plans, drug protocols, clinical documentation, payer policies, and patient benefits • Experience completing insurance authorizations and rechecks • EPIC EHR proficiency • Knowledge of HIPAA, insurance precertification, insurance terminology, managed care, and third-party payers • Experience with insurance claim processing software and medical coding software • Preferred: Associate degree • Preferred: CPC certification from AAPC or RHIT certification from AHIMA • Driver's license is not required

🏖️ 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 a new child • Family care resources for childcare and adult care • Tuition coverage for employees and family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years