Pre-Certification Coordinator I (Remote) - Radiology

UNKNOWN; Missouri; Hybrid; USD 29,000 - 44,000; Full time

Benefits offered by this job

Vacation time

Health insurance

Transit benefit

401(k) retirement plan

Wellness program

Family caregiver leave

Tuition assistance

Job summary

Washington University in St. Louis is seeking a professional to manage pre-determination processes and insurance verifications within a medical office setting. The role includes coordinating with physicians, scheduling surgeries, and maintaining documentation for pre-certifications.

Preferred candidates hold CPC/RHIT credentials and an associate degree, with at least two years of medical office experience. The position supports remote work and offers a comprehensive benefits package.

Qualifications

• Education: High school diploma or equivalent.
• Work Experience: Medical Office Setting (2 Years)
• Certifications/Professional Licenses: CPC and RHIT preferred.
• Driver's License: Not required.

Responsibilities

• Initiates and facilitates pre-determination process.
• Contacts insurance companies for benefit verification and pre-certification; notifies financial counselor for pre-payment.
• Provides documentation required during pre-certification to insurers.
• Maintains daily surgery/procedure schedule and communicates with physicians/assistants.
• Keeps written log of all pre-certifications; notifies billing/utilization.
• Documents receipt of pre-certifications from insurers.
• Performs other duties as assigned.

Skills

Insurance verification

Pre-certification

Communication

Collaboration

Detail-Oriented

Education

Associate degree

Certified Professional Coder (CPC)

Registered Health Information Technician (RHIT)

High school diploma

Job description

Location Remote, US 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.

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.

More About This Job

The successful candidate will have experience obtaining insurance authorizations and pre-determinations for surgical and diagnostic testing, obtaining PCP referral authorizations, authorization appeals, and insurance verifications.

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: Collaboration, Communication, Detail-Oriented, External Customers, HMOs, Insurance, Internal Customers, Interpersonal Communication, Managed Care, Medical Insurance Coding, Organizing, Prioritization, Teamwork, 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

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

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

• Personal Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Take advantage of our free Metro transit U-Pass for eligible employees.
• WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.
• Wellness Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!
• Family We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.
• 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 or shared ancestry, 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. As a federal contractor, the university maintains affirmative action programs to implement its equal employment opportunity policy for individuals with disabilities and protected veterans, in accordance with Section 503 of the Rehabilitation Act of 1973, as amended, and the Vietnam Era Veterans’ Readjustment Assistance Act of 1974 (VEVRAA), as amended.

Q: Can I create a job alert to notify me when jobs of interest are posted?

A: Yes! After you create a Candidate Home account, you can set up and manage job alerts to be sent to you either daily or weekly, according to the filters you select. You can add, edit, or delete job alerts at any time. You will need to opt in to communications from WashU when you set up your first alert and will only receive alerts for jobs posted after the alert has been created.

About WashU

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.

Useful Links and Availability Information

Useful Links Who We Are Human Resources Benefits Living in St. Louis Frequently Asked Questions 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. Regulatory Postings Know Your Rights: Workplace Discrimination is Illegal Poster (English; Spanish)