This hybrid position plays a key role in streamlining patient access to care by handling pre-certification and benefit verification for both surgical and nonsurgical procedures. Working closely with insurance carriers, physicians, and internal teams, the coordinator ensures services are properly authorized and documented to support timely reimbursement.
Key Responsibilities
- Initiate and manage the pre-determination process for medical procedures, confirming coverage with third-party payers.
- Verify patient benefits and obtain necessary pre-authorizations, alerting financial counselors when pre-payment is required for un-coded services.
- Submit all required documentation to insurance companies and maintain records of submissions and responses.
- Keep an up-to-date schedule of upcoming surgeries and procedures, coordinating regularly with physicians and their support staff.
- Log all active pre-certifications and communicate approvals to hospital billing and utilization departments.
- Document receipt of pre-certification decisions and follow up as needed to resolve delays.
- Perform additional administrative and coordination tasks as needed to support departmental operations.
Qualifications
A high school diploma or equivalent is required, along with at least two years of experience in a medical office environment. Strong organizational abilities, clear communication skills, and familiarity with insurance processes are essential. While not required, an associate degree or professional credentials such as CPC (AAPC) or RHIT (AHIMA) may enhance candidacy.
Benefits
- Generous time off: up to 22 vacation days, 10 paid holidays, and sick leave.
- Comprehensive health plans offering lower copays and priority access to care.
- Free Metro transit U-Pass for eligible employees.
- Retirement savings plan (403(b)) with university contributions starting at 7%.
- Wellness resources including health screenings, mental health support, mindfulness programs, and financial counseling.
- Four weeks of caregiver leave for new parents; additional family and adult care resources available.
- Tuition benefits covering 100% for dependents at the institution and 40% elsewhere after seven years of service.
