Job Description
The Pre-Certification coordinator is responsibilities include understanding and verifying benefits for Outpatient, Inpatient and Ambulatory Surgery Services as well as obtaining prior authorization for visits, procedures and hospitalizations, pre-approval, pcp referrals, and predeterminations for all electively scheduled admissions and outpatient surgeries and other designated outpatient visits. In addition, the analyst will at times contact patients/families in order to ascertain additional demographic and insurance information essential to the authorization processes while also informing patients of co-pays that will be due.
Minimum Education Required
Per Classified Civil Svc Specs
Required Qualifications
Required: Per CCS Class Specs: High School Diploma or GED. PC Knowledge and interpersonal, verbal, and written communication. Minimum 6 months experience in customer service or a healthcare environment.
Preferred: Associates Degree and at least 1 year experience in a Patient Revenue role at OSUWMC. Experience with medical terminology and payer requirements preferred. Experience with Windows, Excel, and intranet/internet navigation tools as well as system content.
Demonstrated ability to work in multiple databases and software applications; experience using automated databases for management and reporting. Ability to work in self-directed manner while interacting with consumers, physicians and all medical center faculty and staff. Ability to communicate clearly with health care team.
Career Roadmap:
FUNCTION: Finance
SUB-FUNCTION: Revenue Cycle Pre-certification
CAREER BAND: Individual Contributor - Technical
CAREER LEVEL: T1
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