Senior Pre-certification Coordinator

The Ohio State University

Columbus, OH, US
2 years of relevant experience required
Interpret medical necessity guidelines
Secure complex pre-authorizations
The position is responsible for securing complex pre-authorizations and preventing or appealing clinical denials within the revenue cycle

Job Summary

  • The position is responsible for securing complex pre-authorizations and preventing or appealing clinical denials within the revenue cycle.
  • Staff must utilize clinical knowledge to interpret and apply medical necessity guidelines to determine appropriate services for patients.
  • The role requires becoming a subject matter expert for various insurance carriers and governmental payers to provide accurate information.

Matching Summary

The position is responsible for securing complex pre-authorizations and preventing or appealing clinical denials within the revenue cycle.

Skills & Requirements

Must-have

  • 2 years of relevant experience required
  • interpret medical necessity guidelines
  • secure complex pre-authorizations
  • use electronic medical record systems
  • coordinate with clinical staff

Nice-to-have

  • subject matter expert for insurance carriers
  • flexibility to learn new technology
  • exceptional customer service skills
  • ability to solve complex problems

Key Requirements

  • High School diploma or GED preferred
  • 2 years of relevant experience
  • Certification or vocational training may be required

Work Rights

Not specified

Tailored Resume

Cover Letter