Key skills
Communication
About this role
Role Overview
- Completes pre-certifications for complex and specialized services as indicated on therapy and treatment plans
- Reads and analyzes therapy and treatment plans, drug protocols, and clinical documentation, as well as payer policies and patient benefits
- Completes the authorization process with the payer and in EPIC
- Completes rechecks on existing pre-certifications by verifying insurance eligibility and all authorization information for all applicable services
- Works with clinical staff and providers on add-ons, denials and peer to peers through to resolution
Requirements
- High school diploma or equivalent
- Clinical Office, Medical Billing, Health Information Management, or Pre-Certification (3 Years)
- No specific certification/professional license is required
- Communication skills
- Detail-oriented
- Experience with Epic EHR
- Familiarity with Health Insurance Portability & Accountability Act (HIPAA)
- Understanding of Insurance Terminology and Insurance Claim Processing Software
- Ability to interact with all levels of management
Benefits
- Up to 22 days of vacation
- 10 recognized holidays
- 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 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 your new child
- Covers cost of tuition for you and your family for dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years