Pre-determination/Pre-certification Coordinator 3 job opportunity at Ohio State University.

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DateMore Than 30 Days Ago bot
Ohio State University Pre-determination/Pre-certification Coordinator 3
Experience: 2-years
Pattern: full-time
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degreeAssociate
loacation Health System Shared Services, United States Of America
loacation Health System ..........United States Of America

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu . If you have questions while submitting an application, please review these frequently asked questions . Current Employees and Students: If you are currently employed or enrolled as a student at The Ohio State University, please l og in to Workday to use the internal application process. Welcome to The Ohio State University's career site.  We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following: Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required. Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.  Job Title: Pre-determination/Pre-certification Coordinator 3 Department: Health System Shared Services | Precert Scope of Position The Revenue Cycle for The Ohio State University Wexner Medical Center is responsible for providing excellent customer service, both internal and external, while processing authorization requests to insurance carriers efficiently and accurately. Areas within the Revenue Cycle include pre-registration, registration, pre-certification, financial clearance and counseling, financial assistance, scheduling, billing, claims follow-up, customer service and cash collection. The primary responsibility of staff with Revenue Cycle is to ensure the collection of net accurate, timely, revenue for services rendered. Position Summary The Predetermination / Precertification Coordinator implements and supports the mission, values, standards, policies and procedures of The Ohio State University Wexner Medical Center (OSUWMC). Provides exceptional customer service while ensuring the financial viability of OSUWMC. Functions within the multidisciplinary team to secure complex pre-authorizations and prevent / appeal clinical denials. The job requires the utilization of clinical knowledge to interpret and apply medical necessity guidelines to determine appropriate services. The role requires subject matter experts (SME) for insurance carriers as well as governmental payers. This position is responsible for providing consumers (clinical staff and patients) with accurate, up-to-date information regarding insurance benefits, and authorizations. Assures accurate appointment, demographic and insurance information is gathered to support clinical and financial needs including changes to insurance or other patient information. Provides support to physicians and customers by coordinating their requests and satisfying their needs in one transaction. Solves routine and complex customer problems and knows where to direct customers to address specific questions. Communicate regularly with clinical team, medical staff and other team members within the product/service line to ensure customer and department needs are met. The precertification department uses a variety of tools and communication methods to obtain authorization and must be able to determine the most appropriate method of contact. This includes but is not limited to electronic transactions, numerous web portals, phone calls, and faxes. Flexibility and continuous ability and willingness to learn new technology as it becomes available are essential. Must be able to use a variety of software packages which include the Electronic Medical record, scheduling and registration systems, ABN, eligibility, document management software, etc. Minimum Qualifications Required: High School diploma or GED. Certification or vocational training may be required. Associate degree in relevant field may be preferred. 2 years of relevant experience required. 4-6 years of relevant experience preferred. Preferred: Associate or bachelor’s degree in health-related field. Experience with Windows, Excel, and Intranet/internet navigation tools as well as system content. Medical terminology, coding, and third-party reimbursement experience. Ability to work in multiple systems for assigned tasks, management, and reporting. Strong problem-solving and presentation skills. High level of customer service skills. Able to prioritize and coordinate multiple tasks in a busy environment. Ongoing requirements: Demonstrates competency in daily functions, interpersonal and cognitive skills required to meet essential job functions. Maintains knowledge related to product/service line, quality improvement, cost reduction, current registration and billing policy and procedures as well as scheduling policies and procedures. Must maintain proficiency in utilizing all applicable systems. Must meet mandatory educational and health requirements, as well as ongoing scheduling and registration competencies. Attends Health System and Departmental In-services, education forums, and meetings as required. Additional Information: Location: Ackerman Rd, 660 (0242) Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final candidates are subject to successful completion of a background check.  A drug screen or physical may be required during the post offer process. Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions . The university is an equal opportunity employer, including veterans and disability.  As required by Ohio Revised Code section 3345.0216 , Ohio State will: educate students by means of free, open and rigorous intellectual inquiry to seek the truth; equip students with the opportunity to develop intellectual skills to reach their own, informed conclusions; not require, favor, disfavor or prohibit speech or lawful assembly; create a community dedicated to an ethic of civil and free inquiry, which respects the autonomy of each member, supports individual capacities for growth and tolerates differences in opinion; treat all faculty, staff and students as individuals, hold them to equal standards and provide equality of opportunity with regard to race, ethnicity, religion, sex, sexual orientation, gender identity or gender expression.

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