Remote Pre-Certification Specialist II

Washington University in St. Louis; Missouri; On-site; USD 33,000 - 48,000; Full time

Benefits offered by this job

Vacation time

Health insurance

Transit benefits

Retirement plan

Job summary

Washington University in St. Louis is seeking an Advanced Pre-Certifications Specialist to review complex therapy plans, verify payer requirements, and complete the authorization process in EPIC.

The role involves coordinating with clinical staff to resolve denials and ensure timely approvals, with attention to HIPAA compliance and accurate documentation. The position requires a high school diploma or equivalent and 3+ years in clinical office settings or medical billing.

Qualifications

• High school diploma or equivalent required.
• 3+ years in Clinical Office, Medical Billing, Health Information Management or Pre-Certification.
• Experience with EPIC EHR and payer policies preferred.

Responsibilities

• Completes pre-certifications for complex services per therapy plans and payer policies.
• Performs rechecks of insurance eligibility and verifies authorization information.
• Collaborates with clinical staff and providers to resolve denials and appeals.
• Documents all authorization information in EPIC and communicates with stakeholders.

Skills

Communication

Detail-Oriented

HIPAA

Medical Coding

Interpersonal Communication

Multitasking

Organizational Savvy

Customer Interaction

Education

Associate degree

High school diploma

Tools

Epic EHR

Insurance Claim Processing Software

Precertification Systems

Job description

Washington University in St. Louis is seeking an Advanced Pre-Certifications Specialist to review complex therapy plans, verify payer requirements, and complete the authorization process in EPIC.

The role involves coordinating with clinical staff to resolve denials and ensure timely approvals, with attention to HIPAA compliance and accurate documentation. The position requires a high school diploma or equivalent and 3+ years in clinical office settings or medical billing.