Pre-Certification Coordinator I (South County) - Ophthalmology

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.

Education

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

Preferred Qualifications

Associate degree

Certifications/Professional Licenses

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

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

Work Experience

Medical Office Setting (2 Years)

Skills

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

Salary Range

$21.33 – $31.98 / Hourly

The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

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 and courses, employee assistance program (EAP), financial resources, access to dietitians.
• 4 weeks of caregiver leave to bond with a new child; family care resources and adult care support.
• Tuition coverage for employee and family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years.