Lead Pre-Certification Coordinator; Remote - Department of Medicine

Position Summary:

The position performs professional services to ensure medical, drug, and diagnostic testing authorizations are obtained efficiently and reimbursement is maximized through necessary interaction with third‑party payers. The lead pre‑certification team manages daily workload and resolves questions from staff. Acts as liaison between department facilities and physician offices.

• Lead pre‑certification section in daily activities and prioritize assignments.
• Adjust daily assignments based on coverage needs of team and unit.
• Answer pre‑certification phone lines and assist with billing inquiries, insurance questions, and missing order/pre‑certification issues.
• Serve as liaison between department facilities and physician offices.
• Contact insurance companies for benefit verification and pre‑certification of procedures and testing.
• Provide required documentation to insurers during pre‑certification process.
• Document receipt of pre‑certification and maintain open communication with physicians and assistants about concerns or need for physician involvement.
• Provide training and education to staff.
• Assist staff with complex cases to avoid denials; review denials for potential reconsideration.
• Provide feedback to management on staffing concerns and process improvement, and perform other duties as assigned.

Normal office environment; primarily seated at a desk; repetitive wrist, hand, or finger movements; occasional lifting (≤25 lbs); use of standard office equipment.

• High school diploma or equivalent.
• Minimum 3 years of medical billing/coding experience.
• No specific certification or professional license required.

• Some college or an associate’s degree.
• Certified Professional Coder (CPC) – AAPC, or Registered Health Information Technician (RHIT) – AHIMA.
• Coding experience.
• Thorough understanding of Washington University FSC database and insurance terminology.
• Experience interacting with managed care plans, insurance companies, and third‑party payers.
• Strong communication, detail‑oriented, fast‑paced, interpersonal, multitasking, and organizational skills.

Salary Range: $23.63 – $35.49 per hour (Salary Grade C09‑H). Individual rates within the range are determined by qualifications, performance, equity, market rates, and department budget.

All external candidates receiving an offer will be required to undergo pre‑employment screening, including criminal background check, drug screening, employment/education or licensure/certification verification, physical examination, necessary vaccinations, and other applicable checks subject to the position.

• Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Free Metro transit U‑Pass for eligible employees.
• Defined contribution (403(b)) retirement savings plan with university contributions starting at 7%.
• Wellness challenges, annual health screenings, mental health resources, mindfulness programs, employee assistance program, financial resources, access to dietitians, and more.
• 4 weeks caregiver leave; family care resources for childcare needs.
• Tuition coverage for employees and families: up to 100% for dependent undergraduate‑level college at WashU, and 40% elsewhere after seven years.

Washington University in St. Louis is committed to the principles and practices of equal employment opportunity. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, citizenship (where prohibited by federal law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.