Pre-Certification Coordinator I - Pediatrics Genetics

Location: Saint Louis, MO 63110 | Scheduled Hours: 40

About the Role

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.

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

• Normal working environment.
• Patient care setting.

Physical Effort:

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

Equipment: Office equipment.

Requirements

• High school diploma or equivalent high school certification or combination of education and/or experience.
• 2 years of experience in a medical office setting.

Qualifications

Preferred:

• Associate degree.
• Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
• Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA).

Skills

• Communication
• External Customers
• Insurance
• Internal Customers
• Interpersonal Communication
• Managed Care
• Medical Insurance Coding
• Organizing
• Third Party Payers

Pay

Salary Range: $21.33 - $31.98 / Hourly

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, combining employee contributions and university contributions starting at 7%.
• Wellness challenges, annual health screenings, mental health resources, mindfulness programs, employee assistance program (EAP), financial resources, access to dietitians, and more.
• 4 weeks of caregiver leave to bond with a new child.
• Family care resources for childcare and adult care needs.
• Tuition coverage for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years.