Pre-Certification Coordinator I (South County) - Ophthalmology

Washington University in St. Louis; Missouri; On-site; USD 29,000 - 44,000; Full time

Benefits offered by this job

Vacation time

Health insurance

Transit benefit (U-Pass)

Retirement plan (403(b))

Job summary

Washington University in St. Louis seeks a detail-oriented Healthcare Administrative Specialist to manage pre‑certification and payer communications in a patient‑care setting at Saint Louis.

You will verify benefits, obtain authorizations, and prepare documentation for insurance companies while coordinating with financial counselors and clinical staff. In this role you will maintain daily surgery/procedure schedules, log pre‑certifications, and respond promptly to changes, ensuring timely

Qualifications

• Required: High school diploma or equivalent.
• Preferred: Associate degree.

Responsibilities

• Initiates and facilitates pre-determination process.
• Contacts appropriate insurance companies for benefit verification and pre-certification of 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.

Skills

Communication

External Customers

Insurance

Internal Customers

Interpersonal Communication

Managed Care

Medical Insurance Coding

Organizing

Third Party Payers

Education

High school diploma or equivalent

Associate degree (preferred)

Job description

Location

SAINT LOUIS, MO 63129

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.

Education

• Required Qualifications: 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

WashU seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles.

Preferred Qualifications

• 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.

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, 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.