City/State: Saint Louis, Missouri Categories: Patient Access Shift: Days Job Status: Full-Time Req ID: 86479 Pay Range: $15.00 – $22.33 / hour (Salary or hourly rate is based on job qualifications and relevant work experience) **Additional Information About the Role** Barnes Jewish Hospital is looking to hire a Pre Cert Coord for their growing group! **Additional Preferred Requirements** + In Office Monday - Friday + 8:30-5 PM No weekends or Holidays + Preferred experience: EPIC, Prior Authorization Experience, insurance Verification + This role is for their Pain Management Department **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 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 (https://www.bjctotalrewards.org/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