Pre-Certification Coordinator

Position Summary
Position performs varied professional services to ensure medical/surgical and diagnostic/ancillary services are accomplished in an efficient manner and that reimbursement is maximized through required interaction with third-party payers

Job Description
PRIMARY DUTIES AND RESPONSIBILITIES (Essential Functions)
• Initiates and facilitates predetermination process. %
• Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies financial counselor for prepayment of uncoded services. %
• Supplies all documentation required during pre-certification process to insurance companies. %
• Maintains daily surgery/procedure schedule for department faculty; maintains open communication with physicians and their assistants regarding their schedules. %
• Maintains written log of all pre-certifications in process; notifies hospital utilization/billing department of pre-certification. %
• Documents when pre-certification is received from insurance companies. %

PREFERRED EDUCATION/EXPERIENCE:
• Some college or Associate degree
• RHIT and/or CPC certification, coding experience

CRITICAL SKILLS AND EXPERTISE:
• Excellent communication, interpersonal, and organizational skills requires.
• Experience interacting with managed care plans, insurance companies, and third-party payers.
• Ability to work with internal and external customers, including physicians, nurses, patients, and families.

JOB LOCATION/WORKING CONDITIONS/EQUIPMENT:

Job Location/Working Conditions
• Normal working environment
• Patient care setting

Physical Effort
• Typically sitting at desk or table
• Repetitive wrist, hand or finger movement

Equipment
• Office equipment

APPLICATION SPECIAL INSTRUCTIONS

***********************************************
REQUIRED LICENSURE/CERTIFICATION/REGISTRATION:

DECISION MAKING AND IMPACT:

FINANCIAL/OPERATIONAL IMPACT:

CONTACTS:
Internal –
External –

SUPERVISION:
Given –
Received –

CONFIDENTIAL INFORMATION:
Does the position have regular exposure to confidential material? 0 No X Yes
(If yes, please describe the nature of the materials and specify if patient information is involved)

JOB LOCATION/WORKING CONDITIONS/EQUIPMENT:
Job Location/Working Conditions
Describe the normal conditions under which work is performed. Check as many as apply.

X Normal office environment
0 Requires extensive safety training
0 Exposure to blood-borne pathogens
0 Stockroom or warehouse
0 Alternative work schedules
0 Exposure to chemicals
0 High noise environment
0 On-Call (Beeper)
0 Requires protective devices
0 Dust, dirt, grease or other disagreeable elements
0 Exposure to moving machinery
0 Exposure to animals
X Patient care setting
0 Handling of radioactive material
0 Direct patient care setting
? Ability to travel to various on- and off-campus locations

Physical Effort
Check as many boxes as apply to describe the physical demands of the position.

X Typically sitting at desk or table
0 Typically standing or walking
0 Typically running or climbing
0 Typically bending, crouching, stooping
X Repetitive wrist, hand or finger movement
0 Using tools requiring high dexterity
0 Occasional lifting (25 lbs or less)
0 Occasional lifting (25 – 50 lbs)
0 Frequent lifting 25 lbs or more

Equipment
Check all boxes that apply to the equipment used to perform work associated with this position.

X Office equipment
0 Lab/research equipment
0 Clinical/diagnostic equipment
0 Simple hand tools
0 Heavy equipment (buffers, mowers, forklift, etc.)
0 Other _____________

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.

Required Qualifications

MINIMUM EDUCATION/EXPERIENCE: High school diploma or equivalent high school certification; 3 to 5 years of experience in a medical office setting.

Grade
C08-H

Salary Range
$19.77 – $29.64 / Hourly

The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one’s qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

Accommodation

If you are unable to use our online application system and would like an accommodation, please email [email protected]  or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.

Pre-Employment Screening
All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.

Benefits Statement
Washington University in St. Louis is committed to providing a comprehensive and competitive benefits package to our employees. Benefits eligibility is subject to employment status, full-time equivalent (FTE) workload, and weekly standard hours. Please visit our website at https://hr.wustl.edu/benefits/ to view a summary of benefits.

EEO/AA Statement
Washington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

Diversity Statement
Washington University is dedicated to building a diverse community of individuals who are committed to contributing to an inclusive environment – fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.

Applicant Instructions
When you are ready to apply, creating an account only takes a minute. Your account creates a candidate home page which we will use to communicate with you and allows you to apply for jobs and view your application statuses. The first page of the application offers two “Quick Apply” options. Quick Apply allows you to either use a previous application or create a new application using a resume to populate the work experience and education sections of your job application. If using a resume to populate your application, check to ensure the application fields populated accurately. You may skip the “Quick Apply” page by clicking “Next” at the bottom of the page. Documents may be uploaded in the My Experience section of the application. You also have the option to apply with a LinkedIn feature, which allows you to apply by using your LinkedIn profile to populate some of the job application fields.