Pre-certification Coordinator 1

The Ohio State University; Columbus (OH); Remote; USD 38,000 - 46,000; Full time

Job summary

The Ohio State University Health System is seeking a Pre-certification Coordinator 1 to verify benefits and secure precertifications for outpatient and inpatient services. This role supports coordination of prior authorizations, referrals, and predeterminations across the health system.

Responsibilities include communicating with patients and families to collect necessary data and inform about expected co-pays, while ensuring accurate information for all authorization workflows.

Qualifications

• High School diploma or GED required.
• 6 months relevant health care or revenue cycle experience or customer service experience.
• Experience with medical terminology and payer requirements preferred.

Responsibilities

• Coordinate insurance verification and precertification for outpatient procedures, inpatient admissions, and surgeries.
• Obtain prior authorization, pre-approvals, PCP referrals, and predeterminations for elective admissions.
• Contact patients/families to gather demographic/insurance information and inform about co-pays.

Skills

Healthcare experience

Customer service

Clear communication

Self-directed work

Interacting with physicians

Education

High School diploma or GED

Tools

Windows

Excel

Job description

Job Title: Pre-certification Coordinator 1

Department: East | Precert and Financial Counseling

Scope of Position

The Ohio State University Health System is committed to improving access and service to customer. The Pre-Certification position functions as an integral member of the health care team to reflect a culture of cooperation, enthusiasm and mutual respect. This position ensures the coordination of the insurance verification and precertification process for all outpatient procedures, inpatient admissions and outpatient surgeries and other designated services for patients to The Ohio State University Health System.

Position Summary

The Pre-Certification coordinator’s responsibilities include understanding and verifying benefits for Outpatient, Inpatient and Ambulatory Surgery Services as well as obtaining prior authorization for visits, procedures and hospitalizations, pre-approval, PCP referrals, and predeterminations for all electively scheduled admissions and outpatient surgeries and other designated outpatient visits. In addition, the analyst will at times contact patients/families to determine additional demographic and insurance information essential to the authorization processes while also informing patients of co-pays that will be due.

Minimum Qualifications

High School diploma or GED, and 6 months Relevant Experience in Health Care Setting/Existing, Revenue Cycle Department OR Customer Service Experience OR Experience with authorization work in an insurance company, physician practice, or hospital setting. Experience with medical terminology and payer requirements preferred. Experience with Windows, Excel, and intranet/internet navigation tools as well as system content. Demonstrated ability to work in multiple databases and software applications; experience using automated databases for management and reporting. Ability to work in self-directed manner while interacting with consumers, physicians and all medical center faculty and staff. Ability to communicate clearly with health care team.

FUNCTION: Finance

SUB-FUNCTION: Revenue Cycle Pre-certification

CAREER BAND Individual Contributor - Technical

CAREER LEVEL: 1

Additional Information:Location:Remote LocationPosition Type:RegularScheduled Hours:40Shift:First Shift

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

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The university is an equal opportunity employer, including veterans and disability.