Pre-certification Coordinator 1

Ohio State University • Columbus, OH

389d

About The Position

The Pre-Certification Coordinator 1 at The Ohio State University Health System plays a crucial role in ensuring the coordination of insurance verification and precertification processes for various patient services. This position is integral to the healthcare team, promoting a culture of cooperation and respect while facilitating access to necessary medical services for patients.

Requirements

• High School diploma or GED.
• 6 months of relevant experience in a healthcare setting, revenue cycle department, or customer service experience.
• Experience with authorization work in an insurance company, physician practice, or hospital setting is preferred.
• Familiarity with medical terminology and payer requirements is preferred.
• Experience with Windows, Excel, and intranet/internet navigation tools.
• Demonstrated ability to work in multiple databases and software applications.

Nice To Haves

• Experience using automated databases for management and reporting.
• Ability to work in a self-directed manner while interacting with consumers, physicians, and medical center staff.
• Strong communication skills to interact clearly with the healthcare team.

Responsibilities

• Coordinate the insurance verification and precertification process for outpatient procedures, inpatient admissions, and outpatient surgeries.
• Understand and verify benefits for Outpatient, Inpatient, and Ambulatory Surgery Services.
• Obtain prior authorization for visits, procedures, and hospitalizations, including pre-approval, PCP referrals, and predeterminations.
• Contact patients and families to gather additional demographic and insurance information essential for authorization processes.
• Inform patients of co-pays that will be due prior to services.

Benefits

• Regular scheduled hours with a full-time commitment.
• Opportunities for professional development and growth within the healthcare system.

What This Job Offers

• Job Type: Full-time
• Industry: Educational Services
• Education Level: High school or GED