Pre-Certification Coordinator; Remote - Department of Medicine - Business Office

Employer Industry: Healthcare Services

• Salary up to $34.21 per hour
• Opportunity for career advancement and growth within the organization
• Competitive health insurance packages with priority appointments and lower copays/coinsurance
• Up to 22 days of vacation, 10 recognized holidays, and sick time
• Supportive and collaborative work environment
• Tuition coverage for employees and their families after seven years of service

• Complete pre-certifications for complex and high-dollar drugs based on therapy and treatment plans
• Verify insurance eligibility and authorization information for existing pre-certifications
• Collaborate with clinical staff and providers to resolve add-ons, denials, and peer-to-peer issues
• Document all pertinent authorization information in the Epic system
• Assist with denials, rejections, and appeals as needed

• High school diploma or equivalent high school certification or combination of education and/or experience
• Minimum of 3 years of experience in Clinical Office, Medical Billing, Health Information Management, or Pre-Certification
• No specific certification/professional license is required for this position
• Ability to work with internal and external customers, including physicians, nurses, patients, and families
• Strong communication and organizational skills

• Previous coding and pre-certification experience
• Thorough understanding of insurance terminology and managed care plans
• Experience interacting with insurance companies and third-party payers
• Associate degree in a relevant field
• Certification as a Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT)

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