Pre - Certification Coordinator II (Remote) - Department of Medicine

Washington University in St. Louis

Job Overview

Location

Remote

Job Type

Full-time

Full Job Description

📋 Description

• The Pre-Certification Coordinator II is a remote role within the Department of Medicine at Washington University in St. Louis, responsible for ensuring accurate and timely pre-certifications for complex therapies and treatments to prevent financial losses from denied claims.
• Day-to-day duties include analyzing therapy and treatment plans, drug protocols, and clinical documentation; verifying insurance eligibility and authorization details with payers; completing authorization processes in EPIC; performing rechecks on existing certifications; collaborating with clinical staff and providers to resolve denials, add-ons, and peer-to-peer reviews; and assisting with appeals and reimbursement issues.
• The Department of Medicine at WashU is committed to excellence in patient care, research, and education, and this role supports clinical operations by ensuring financial and administrative compliance with insurance requirements.
• In this role, the individual will develop deep expertise in medical insurance processes, EPIC EHR navigation, managed care policies, and healthcare reimbursement systems, while strengthening communication, prioritization, and problem-solving skills in a fast-paced clinical environment.

🏖️ Benefits

• 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 matching starting at 7%
• Tuition waiver for employees and family members (up to 100% at WashU after seven years)
• Wellness programs including mental health resources, EAP, health screenings, and financial counseling

Skills & Technologies

Remote

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Washington University in St. Louis

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About Washington University in St. Louis

Washington University in St. Louis is a private research university founded in 1853. It offers undergraduate, graduate, and professional programs across seven schools, including Arts & Sciences, Engineering, Medicine, Law, and Business. Located in St. Louis, Missouri, the university is classified as an R1 doctoral university with very high research activity. It operates a 169-acre Danforth Campus and a 164-acre Medical Campus, along with the Tyson Research Center. The university is affiliated with Barnes-Jewish Hospital and conducts extensive interdisciplinary research in biomedicine, engineering, social policy, and the arts.

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