Pre-Certification Specialist I — Medical Benefits & Scheduling

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

Benefits offered by this job

Vacation & holidays

Health insurance

Metro U-Pass

Tuition assistance

Job summary

Washington University in St. Louis in Saint Louis, MO 63110 invites applications for a position performing professional services to ensure medical/surgical and diagnostic/ancillary services are completed efficiently and that reimbursements are maximized through interactions with third-party payers.

The role includes initiating pre-certification, contacting insurers for benefit verification, supplying required documentation, and maintaining schedules and logs to support the department and

Qualifications

• High school diploma or equivalent high school certification or combination of education and/or experience.
• Medical office setting experience (2 years)
• Strong communication and organizational skills
• Experience with insurance verification and pre-certification processes

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.

Skills

Communication

External Customers

Insurance

Internal Customers

Interpersonal Communication

Managed Care

Medical Insurance Coding

Organizing

Third Party Payers

Education

Associate degree

Job description

Washington University in St. Louis in Saint Louis, MO 63110 invites applications for a position performing professional services to ensure medical/surgical and diagnostic/ancillary services are completed efficiently and that reimbursements are maximized through interactions with third-party payers.

The role includes initiating pre-certification, contacting insurers for benefit verification, supplying required documentation, and maintaining schedules and logs to support the department and