Pre-Certification Coordinator II - Pediatric Endocrinology

Washington University in St. Louis; St. Louis (MO); On-site; USD 33,062 - 49,593; Full time

Benefits offered by this job

Vacation & holidays

Health insurance

Transit/Metro pass

403(b) retirement plan

Job summary

Washington University in St. Louis is seeking a staff member to handle prior authorization for medical, surgical, and diagnostic services. The role ensures efficient service delivery and maximizes reimbursement via payer interactions.

40 hours per week; non‑patient facing with a normal desk environment. Requires a high school diploma; associate degree preferred. Prior experience in clinical office billing or HIM is expected.

Qualifications

• High school diploma or equivalent required, associate degree preferred.
• Experience with pre‑certification, medical billing and HIM.
• Familiarity with Epic EHR and coding terminology.
• Ability to handle fast‑paced workflows while maintaining accuracy.

Responsibilities

• Initiate and facilitate prior authorization process.
• Contact insurance companies for benefit verification and pre‑certification.
• Provide documentation required during pre‑certification to payers.
• Maintain logs and notify relevant departments of pre‑certifications.
• Perform other duties as assigned.

Skills

Communication

Detail‑Oriented

Epic EHR

Fast‑Paced Environments

HIPAA

Insurance Claim Processing Software

Insurance Precertification

Insurance Terminology

Interpersonal Communication

Medical Coding Software

Multitasking

Organizational Savvy

Prioritization

Education

High school diploma

Associate degree

Tools

Epic EHR

Medical Coding Software

Insurance Claim Processing Software

Insurance Precertification Tools

Job description

Position Summary

The position performs prior‑authorization services to ensure medical/surgical and diagnostic/ancillary services are accomplished in an efficient manner and that reimbursement is maximized through required interaction with payers.

Scheduled Hours

40 hours per week.

Primary Duties & Responsibilities

• Initiate and facilitate prior authorization process.
• Contact appropriate insurance companies for benefit verification and pre‑certification of surgical and nonsurgical procedures, outpatient testing, and medications; notify financial counselor for pre‑payment of un‑coded services.
• Supply all documentation required during pre‑certification process to insurance companies.
• Maintain written log of all pre‑certifications in process; notify hospital utilization/billing department of pre‑certification.
• Document when pre‑certification is received from insurance companies.
• Perform other duties as assigned.

Working Conditions

• Normal working environment.
• Non‑patient facing.

Physical Effort

• Typically sitting at a desk or table.
• Repetitive wrist, hand or finger movement.

Equipment

• Office equipment.

Education

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

Certifications / Professional Licenses

No specific certification or professional license is required for this position.

Work Experience

Clinical Office, Medical Billing, Health Information Management (HIM), or Pre‑Certification (3 years).

Skills

• Communication, Detail‑Oriented, Epic EHR, Fast‑Paced Environments, HIPAA, Insurance Claim Processing Software, Insurance Precertification, Insurance Terminology, Interpersonal Communication, Medical Coding Software, Multitasking, Organizational Savvy, Prioritization.

Driver's License

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

Preferred Qualifications

Associate degree.

Preferred Certifications / Licenses

Certified Professional Coder (CPC) – American Academy of Professional Coders (AAPC); Registered Health Information Technician (RHIT) – American Health Information Management Association (AHIMA).

Grade

C09‑H

Salary Range

$23.63 – $35.49 per hour.

Benefits

• 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 with employee and university contributions starting at 7%.
• Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program, financial resources, access to dietitians.
• 4 weeks of caregiver leave to bond with your new child; family care resources for continued childcare needs; adult care coverage.
• WashU covers 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.

Equal Employment Opportunity 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.