Key skills
Communication
About this role
Role Overview
- Leads the pre-certification section in daily activities and prioritization of assignments
- Assists in adjusting daily assignments based on coverage needs of the team and unit
- Answers the pre-certification phone lines; assists with billing inquiries, insurance questions, and missing order and pre-certification issues
- Acts as liaison between department facilities and physician offices
- Contacts appropriate insurance companies for benefit verification and pre-certification of procedures and testing
- Supplies all documentation required during pre-certification process to insurance companies
- Documents when pre-certification is received from insurance companies and maintains open communication with physicians and their assistants regarding concerns or when physician involvement is needed
- Provides training and education to staff
- Assists staff with complex cases avoiding denials and physician peer to pears
- Reviews denials to see if there is a potential for re-consideration
- Provides feedback to management regarding staffing concerns and process improvement
Requirements
- High school diploma or equivalent high school certification or combination of education and/or experience
- Medical Billing/Coding (3 Years)
- Previous pre-certification experience
- Some college or an associate’s degree preferred
- Coding experience preferred
- Thorough understanding of Washington University FSC database and insurance terminology
- Experience interacting with managed care plans, insurance companies, and third-party payers
- Ability to work with internal and external customers, including physicians, nurses, patients, and families
- Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT) preferred
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 with 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 new child
- Family care resources for continued childcare needs
- Tuition coverage for employees and family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us