About The Position

Position provides supervision and oversight of the day to day operations of the predetermination/precertification process, and counsels patients and/or families on options for financial assistance.

Requirements

  • A diploma, certification or degree is not required.
  • No specific certification/professional license is required for this position.
  • No specific work experience is required for this position.
  • Not Applicable
  • A driver's license is not required for this position.

Nice To Haves

  • Precertification and/or medical management experience is preferred.
  • Associate degree
  • No additional certification/professional licenses unless stated elsewhere in the job posting.
  • No additional work experience unless stated elsewhere in the job posting.
  • Coaching
  • Customer Service
  • Insurance Precertification
  • Medical Management
  • Mentorship
  • Process Improvements
  • Supervisory Management
  • Time Management

Responsibilities

  • Develops, implements and ensures adherence to policy and procedures to optimize the pre-certification process and minimize dollars lost to lack of pre-certification.
  • Initiates and facilities pre-determination process.
  • Directly interacts with patients regarding non-coverage and develops a self-pay financial plan.
  • Works with faculty and clinical staff regarding self-pay package pricing and financial coordination plans for patients.
  • Works with involved departments to ensure agreement with developed financial plans.
  • Monitors volumes through reporting to ensure appropriate staffing levels.
  • Adjusts workload distributions as needed.
  • Interacts with representatives of major third-party carriers to resolve prior approval/pre-certification problems and discuss changes in third-party program requirements.
  • Participates in selection process of new employees, training, supervising and evaluating employees; informs employees of changes in the department.
  • Assists with coverage in staff areas during illness/vacations.
  • Performs other duties as assigned.

Benefits

  • Up to 22 days of vacation, 10 recognized holidays, and sick time.
  • Competitive health insurance packages with priority appointments and lower copays/coinsurance.
  • Take advantage of our free Metro transit U-Pass for eligible employees.
  • WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and 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, and more!
  • We offer 4 weeks of caregiver leave to bond with your new child.
  • Family care resources are also available for your continued childcare needs.
  • Need adult care? We’ve got you covered.
  • WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.
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