What are the responsibilities and job description for the Pre-Cert Coordinator position at BJC HealthCare?
- 730-4pm Monday - Friday
- onsite at MCC for Ambulatory Services
- No weekends
- Full Time and Daily Pay
- Daily Duties: Working WQs for Referrals, Faxes ( OnBase) and Pre- Certs. Sending letters to patients and sending teams messages to the departments and calling patients.
Overview
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 GED
Experience
- 2-5 years
Supervisor Experience
- No Experience
Preferred Requirements
Education
- Bachelor's Degree
Benefits 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 date
- Disability insurance* paid for by BJC
- Pension Plan*/403(b) Plan funded by BJC
- 401(k) plan with BJC match
- Tuition Assistance available on first day
- BJC Institute for Learning and Development
- Health Care and Dependent Care Flexible Spending Accounts
- Paid Time Off benefit combines vacation, sick days, holidays and personal time
- Adoption assistance
To learn more, go to www.bjctotalrewards.com/Benefits
- 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
