Pre-Certification Coordinator II

Job not on LinkedIn

🕒 August 4

🇺🇸 United States – Remote

💵 $23 - $35 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 13%

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Logo of WashU IT

WashU IT

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 indicated 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 • No specific certification/professional license is required • Driver's license is not required • Ability to complete complex and specialized pre-certifications • Ability to read and analyze therapy and treatment plans, drug protocols, clinical documentation, payer policies, and patient benefits • Ability to use EPIC and insurance claim processing/precertification software • Knowledge of insurance terminology, managed care, third-party payers, and HIPAA • Preferred: Associate degree • Preferred: Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT)

🏖️ Benefits

• Up to 22 days of vacation, 10 recognized holidays, and 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 employee and 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, and more • 4 weeks of caregiver leave to bond with your new child • Family care resources for continued childcare needs • Adult care resources • Tuition covered for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us

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