Pre-Certification Coordinator II (Remote) - Department of Medicine

Washington University in St. Louis-posted 5 days ago
$23 - $34/Yr
Full-time • Mid Level
Remote • Hammond, LA
5,001-10,000 employees
Resume
Match Score
Upload and Match ResumeTrack Jobs with Teal

Advanced level specialization in complex pre-certifications as indicated on therapy and treatment plans to prevent controllable losses/write offs for the Department. May perform rechecks of insurance eligibility and verify authorization information for each service. Documents all pertinent authorization information in EPIC and communicates with clinical staff and providers in a timely and effective manner.

  • Completes pre-certifications for complex and high dollar drugs as indicated on therapy and treatment plans.
  • Must read and analyze 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 all 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.
  • Other duties as assigned, such as assistance with denials, rejections and appeals.
  • High school diploma or equivalent high school certification or combination of education and/or experience.
  • Clinical Office, Medical Billing, Health Information Management (Him), Or Pre-Certification (3 Years)
  • Associate degree
  • Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC)
  • Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)
  • Communication
  • Detail-Oriented
  • Epic EHR
  • Fast-Paced Environments
  • Health Insurance Portability & Accountability Act (HIPAA)
  • Insurance Terminology
  • Interpersonal Communication
  • Multitasking
  • Organizational Savvy
  • Prioritization
  • Up to 22 days of vacation, 10 recognized holidays, and sick time.
  • Competitive health insurance packages with priority appointments and lower copays/coinsurance.
  • Take advantage of our free Metro transit U-Pass for eligible employees.
  • WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions 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!
  • We offer 4 weeks of caregiver leave to bond with your new child.
  • Family care resources are also available for your continued childcare needs.
  • Need adult care? We’ve got you covered.
  • 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.
Track Jobs with Teal

Job Search Resources

•
Resume Builder
•
Resume Examples
•
Cover Letter Examples

Tools

Career Hubs

Guides

Company

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service