Pre-certification Coordinator 1

The Ohio State University Wexner Medical Center; Northern (KY); Hybrid; USD 42,000 - 54,000; Full time

Job summary

The Ohio State University Health System is seeking a Pre-certification Coordinator 1 to support insurance verification and precertification for outpatient and inpatient services in the revenue cycle. You will verify benefits and obtain prior authorizations for visits, procedures, and hospitalizations.

The role involves contacting patients to gather information, informing them of potential co-pays, and coordinating with care teams to ensure timely approvals.

Qualifications

• High School diploma or GED, and 6 months relevant experience in healthcare or revenue cycle.
• Experience with authorization work in a physician practice, hospital, or insurance setting preferred.
• Familiar with medical terminology; proficient with Windows and Excel.
• Ability to work across multiple databases and software applications; good communication with health care team.

Responsibilities

• Coordinate insurance verification and precertification for outpatient and inpatient services.
• Obtain prior authorization, pre-approvals, PCP referrals, and predeterminations.
• Contact patients to collect demographic and insurance details; explain co-pays.

Skills

Healthcare experience

Revenue Cycle

Customer Service

Authorization work

Medical terminology

Windows

MS Excel

Database navigation

Education

High School diploma or GED

Tools

MS Excel

Database systems

Job description

## Pre-certification Coordinator 1Apply: Remote: Remote Location: Full time: Posted Today: R158861Screen reader users may encounter difficulty with this site. For assistance with applying, please contact [e-mail]. If you have questions while submitting an application, please review these frequently asked questions.**Current Employees and Students:**If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process.Welcome to The Ohio State University's career site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:* Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.* Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.## 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 Location## Position Type:Regular## Scheduled Hours:40## **Shift:**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.***