Pre-Certification & Benefits Verifications Coordinator

The Ohio State University Wexner Medical Center; Kentucky; On-site; USD 40,000 - 52,000; Full time

Job summary

The Ohio State University Health System seeks a Pre-Certification Coordinator to verify benefits for outpatient, inpatient, and ambulatory services and obtain prior authorization for visits and procedures.

The role involves contacting patients to gather demographic and insurance information, determining predeterminations, and communicating expected co-pays. Strong knowledge of payer requirements and medical terminology is preferred.

Qualifications

• High School diploma or GED.
• 6 months relevant experience in health care setting/revenue cycle or customer service.
• Experience with authorization work in an insurance company, physician practice, or hospital setting.
• Experience with Windows, Excel, and intranet/internet navigation tools and system content.
• Ability to work in multiple databases and software applications; communicate clearly with health care team.

Responsibilities

• Verify benefits for outpatient, inpatient and ambulatory services and obtain prior authorization.
• Coordinate pre-certification and predeterminations for scheduled visits and surgeries.
• Contact patients/families to obtain demographic and insurance information essential to authorization processes.
• Inform patients of co-pays that will be due.

Skills

Customer service

Medical terminology

Authorization work

Education

High School diploma or GED

Tools

Windows

Excel

Job description

The Ohio State University Health System seeks a Pre-Certification Coordinator to verify benefits for outpatient, inpatient, and ambulatory services and obtain prior authorization for visits and procedures.

The role involves contacting patients to gather demographic and insurance information, determining predeterminations, and communicating expected co-pays. Strong knowledge of payer requirements and medical terminology is preferred.