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Job Information

Washington University of St. Louis Pre-Certification Coordinator - Medical Oncology - 50557 in St. Louis, Missouri

Job Type/Schedule

This position is full-time and works approximately 40 hours per week.

Department Name/Job Location

This position is in the Department of Internal Medicine, Division of Oncology. The position is located at the Center for Advanced Medicine. This position is for the Medical School Campus.

Essential Functions

POSITION SUMMARY:

Position performs varied professional services to ensure treatment room drug/services are reviewed, appropriate and approved for insurance/payment coverage. Performed in an efficient manner and that reimbursement is maximized through required interaction with third-party payers.

PRIMARY DUTIES AND RESPONSIBILITIES:

  1. Completes additional assignments from supervisor.
  2. Initiates and facilitates predetermination process. Verifies that an authorization/referral is approved and in place with any primary/secondary insurance, to meet the scheduled appointment of the patient for treatment to avoid any treatment delays.
  3. Contacts appropriate insurance companies for benefit verification and pre-certification of procedures. Coordinates and pursues insurance approval of any off-label drug, works with Supervisor to coordinate and achieve peer to peer for insurance approval.
  4. Supplies all documentation required during pre-certification process to insurance companies. Confirms benefit check information is in place for possible co-pay assistance program enrollment consideration and communicates to Oncology Billing Team and/or Front Desk to coordinate drug assistance enrollment with patient.
  5. Recognizes and proactively communicates to the physician/medical team regarding non-contracted insurance plans.
  6. Maintains log of all pre-certifications in place, and have an authorization in place.

Required Qualifications

  • High school diploma or equivalent high school certification.
  • Three to five years of experience in a medical office setting.

Preferred Qualifications

  • Some college or an associate degree.
  • RHIT and/or CPC certification.
  • Previous coding experience.

Salary Range

The hiring range for this position is $18.81 - $23.52 per hour.

Pre-Employment Screening

All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. Current employees applying for a new position within the university may be subject to this requirement. The screenings will include a criminal background check and, as applicable for the position, other background checks, drug screen, employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.

Benefits

This position is eligible for full-time benefits. Please click the following link to view a summary of benefits: https://wustl.box.com/s/8wkhs25yssf0775x9d6nd6vqa7obpth7.

EOE Statement

Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.

Job Title: Pre-Certification Coordinator - Medical Oncology - 50557

Job ID: 50557

Location: Medical School

Full/Part Time: Full-Time

Regular/Temporary: Regular

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