About the Role
Seeks highly motivated individuals capable of performing responsibilities in alignment with the organization's core mission and guiding principles.
Responsibilities
- Processes pre-authorization requests for specialized orthopedic services by reviewing treatment plans, clinical records, drug regimens, and insurance requirements, then finalizes approvals with payers and enters data into EPIC.
- Conducts periodic reviews of active pre-certifications by validating insurance coverage and authorization details for all relevant procedures, ensuring updated information is recorded in EPIC.
- Collaborates with medical teams and providers to resolve issues related to service additions, claim denials, and peer-to-peer insurance reviews within established timelines.
- Supports additional tasks as needed, including handling denied claims, rejected submissions, and appeal processes.
Benefits
- Accrue up to 22 days of paid vacation annually, plus 10 recognized holidays and sick leave.
- Access to competitive health insurance plans offering reduced copays, coinsurance, and priority access to care.
- Eligible employees receive a complimentary regional transit U-Pass at no cost.
- Eligible staff participate in a 403(b) Retirement Savings Plan featuring a 7% minimum combined contribution from the employer and employee.
- Comprehensive wellness offerings include mental health support, mindfulness training, annual health assessments, financial counseling, employee assistance programs, and dietitian access.
- Four weeks of paid caregiver leave available for bonding with a new child, along with resources for ongoing childcare and adult care needs.
- Tuition support includes full undergraduate tuition coverage for dependents at the institution and 40% reimbursement at other institutions after seven years of employment.
Work Arrangement
Remote (Worldwide)
More About This Job
Seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles.
Accommodation
Applicants unable to use the online application system may request assistance by emailing CandidateQuestions@wustl.edu or calling 314-935-1149 and leaving a voicemail detailing their accommodation need. Reasonable accommodations will be provided to qualified individuals with disabilities to perform essential job functions, provided it does not impose undue hardship.
EEO Statement
The institution adheres to equal employment opportunity principles and actively welcomes candidates from underrepresented groups. It ensures equitable access in hiring regardless of race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, veteran status, or genetic information. The organization values diversity and inclusion and encourages applicants committed to fostering a respectful, equitable environment.
Questions
For common inquiries about applying, consult the External Applicant FAQ.
Other
- Scheduled Hours: 40
- Job Location/Working Conditions: Normal office environment.
- Physical Effort: Typically sitting at desk or table.
- Equipment: Office equipment.
- Pre-Employment Screening: criminal background check, drug screen, employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks.
- All offers are contingent upon successful completion of required screening.
