Senior Pre-Certification Coordinator

Job Title Senior Pre-Certification Coordinator 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 Patient Access Coordinator 3 implements and supports the mission, values, standards, policies and procedures of The Ohio State University Wexner Medical Center (OSUWMC). The PAC‑3 provides exceptional customer service while ensuring the financial viability of OSUWMC. The PAC‑3 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 the PAC‑3 to become 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 High School diploma or GED preferred. Certification or vocational training may be required. 2 years of relevant experience required. Functional and Career Information Function: Finance Sub‑Function: Revenue Cycle Pre‑certification Career Band: Individual Contributor - Technical Career Level: 3 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. Equal Opportunity Employer The university is an equal opportunity employer, including veterans and disability. Benefits Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost. Paid time off, including sick and vacation time and 11 holidays. State retirement plan or an alternative retirement plan, both with generous employer contributions. #J-18808-Ljbffr Ohio State University