Pre-Certification Coordinator I - Pediatrics Genetics

Washington University; Missouri; On-site; USD 29,000 - 44,000; Full time

Job summary

Washington University in St. Louis in Saint Louis, MO, is seeking a pre-certification specialist to help maximize reimbursement by coordinating with third-party payers and supporting clinicians.

The role handles pre-determination, benefit verification, and documentation for insurance providers, while maintaining schedules and communicating with physicians and staff. A high school diploma is required; CPC/RHIT credentials are preferred.

Qualifications

• Education: High school diploma or equivalent.
• Certifications/Professional Licenses: No specific certification/professional license required.
• Work Experience: Medical Office Setting (2 Years)
• Skills: Not Applicable
• Driver's License: A driver's license is not required for this position.

Responsibilities

• Initiates and facilitates pre-determination process.
• Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies financial counselor for pre‑payment of un‑coded 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.
• Performs other duties as assigned.

Education

High school diploma or equivalent

Associate degree

Job description

Location SAINT LOUIS, MO 63110 Scheduled Hours 40

Position Summary 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.

Primary Duties & Responsibilities

• Initiates and facilitates pre-determination process.
• Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies financial counselor for pre‑payment of un‑coded 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.
• Performs other duties as assigned.

Working Conditions

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.

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

Education: High school diploma or equivalent high school certification or combination of education and/or experience.

Certifications/Professional Licenses: No specific certification/professional license is required for this position.

Work Experience: Medical Office Setting (2 Years)

Skills: Not Applicable

Driver's License: A driver's license is not required for this position.

Preferred Qualifications

Education: Associate degree

Certifications/Professional Licenses: Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)

Work Experience: No additional work experience unless stated elsewhere in the job posting.

Skills: Communication, External Customers, Insurance, Internal Customers, Interpersonal Communication, Managed Care, Medical Insurance Coding, Organizing, Third Party Payers

Grade C08-H Salary Range

$21.33 - $31.98 / 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.

Questions

For frequently asked questions about the application process, please refer to our External Applicant FAQ.

Accommodation

Accommodation If you are unable to use our online application system and would like an accommodation, please email [e-mail] or call the dedicated accommodation inquiry number at 314‑935‑1149 and leave a voicemail with the nature of your request. All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.

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

• Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Free Metro transit U‑Pass for eligible employees.
• 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!
• 4 weeks of caregiver leave to bond with your new child.
• Family care resources are also available for your continued childcare needs.
• Adult care coverage assistance.
• 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.

For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/

EEO Statement

Washington University in St. Louis is committed to the principles and practices of equal employment opportunity. 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, citizenship (where prohibited by federal law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

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Washington University in St. Louis' collective success is significantly attributed to the passion and outstanding efforts of our community. Our staff, faculty and trainees are committed to excellence and dedicated to carrying out our missions of research, teaching and patient care. WashU prides itself on being a place where people matter, and serious work is done. Our people work together in an inclusive community that celebrates diverse perspectives, collaboration and innovation. We are a community of individuals inspired to work together to develop big ideas and tackle challenging problems. We value the well-being of our people. WashU strives to create a positive employee experience where staff, faculty and trainees thrive, both personally and professionally. Our employees find meaning, connection and vitality in their work and life with a healthy work‑life balance and support to learn, grow and make an impact at WashU, the community and the world.

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