Pre-Certification Coordinator I (South County) - Ophthalmology

Washington University; St. Louis, Northern (MO, KY); Hybrid; USD 29,000 - 44,000; Full time

Benefits offered by this job

Vacation time

Health insurance

Metro U-Pass transit program

403(b) retirement savings plan

Tuition assistance

Job summary

Washington University in St.Louis in Saint Louis, MO, seeks a professional to manage pre‑determination, coordinate with insurers, and support scheduling and billing for surgical and diagnostic procedures.

The role requires a high school diploma or equivalent, with preferred CPC/RHIT certifications and 2 years in a medical office setting. This is a full-time, on-site position with strong benefits and tuition support programs.

Qualifications

• Education: High school diploma or equivalent; combination of education and experience acceptable.
• Certifications/Licenses: CPC and RHIT preferred for this role.
• Work Experience: Medical office setting typically 2 years.
• Skills: Not applicable
• Driver's License: Not required.

Responsibilities

• Initiates and facilitates the pre-determination process.
• Contacts insurance companies for benefit verification and pre-certification.
• Provides documentation required for pre-certification to insurers.
• Maintains department surgery/procedure scheduling and communicates with physicians.
• Keeps written log of pre-certifications and notifies billing when needed.
• Documents receipt of pre-certifications from insurers and performs other duties as assigned.

Education

High school diploma or equivalent

Associate degree

CPC Certification

RHIT Certification

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.

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

Salary

Grade C08-H Salary Range $21.33 - $31.98 / Hourly

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 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.

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.

About Us

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.