Center For advanced Medicine is looking to hire a Pre Cert Coordinator for their Pain Management Department.
Additional Preferred Requirements
Monday -Friday Full Time onstie 8:30-5 PM No weekends or Holidays This person will handle Prior Authorizations for their Pain Management Department will be in charge of obtaining the Prior authorization in ordr for the patient to be scheduled Daily Pay!Overview
Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center.
The Department of Ambulatory Services at Barnes-Jewish Hospital consists of the multidisciplinary staff of BJH Ambulatory Services including responsibility for the GI Labs, Minor Procedure Center, Pain Management Center, Diabetes Center, Resident Clinics, Wound/Ostomy Center and other services as assigned. This department assures that all customers receive the highest level of attention and prompt, courteous service.
Preferred Qualifications
Role Purpose
Works in coordination with other departmental and hospital staff to ensure reimbursement for care rendered by facility including pre-certification with external and on-site reviewers for tests and procedures. Responsible for completing the necessary data elements in a timely and efficient manner in order to financially clear all patients prior to their scheduled visit and all inpatient encounters.
Responsibilities
Authorizations (inpatient, ancillary and surgery): Contacts provider offices, payors and/or payor websites to secure and validate authorization information. A review of medical records may be required if initiating the authorization request directly with a payor. Follow up on post review of insurance mismatch.Complete quality review of all inpatient encounters to ensure financial clearance to avoid reimbursement delays.Collaborates with case management department and third party payors to ensure timely notification of inpatient encounters.Utilize payor logs and various reports to ensure all authorization documentation is accurate and complete for financial clearance. Provides additional follow-up and coordination between case management and payors to obtain clinical information to finalize authorization.Minimum Requirements
Education
High School Diploma or GEDExperience
2-5 yearsSupervisor Experience
No ExperiencePreferred Requirements
Education
Bachelor's DegreeBenefits and Legal Statement
BJC Total Rewards
At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire dateDisability insurance* paid for by BJCAnnual 4% BJC Automatic Retirement Contribution401(k) plan with BJC matchTuition Assistance available on first dayBJC Institute for Learning and DevelopmentHealth Care and Dependent Care Flexible Spending AccountsPaid Time Off benefit combines vacation, sick days, holidays and personal timeAdoption assistanceTo learn more, go to our Benefits Summary
*Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer