For the protection of patients, team members and all who enter our facilities, BJC has made the decision to require COVID-19 vaccination for all team members, unless granted medical or religious exemption, as a condition of employment.

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COORD, PRE-CERT

Job Description

Additional Job Information

  • 40 Hours per Week -

  • Job ID: 1222984
    Employment Status: Full-Time
    More Information:

    Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center.

    The Alvin J. Siteman Cancer Center¿at Barnes-Jewish Hospital and Washington University School of Medicine¿is an international leader in cancer treatment, research, prevention, education and community outreach. It is the only cancer center in Missouri and within a 240-mile radius of St. Louis to hold the prestigious Comprehensive Cancer Center designation from the National Cancer Institute and membership in the National Comprehensive Cancer Network. Parent institutions Barnes-Jewish Hospital and Washington University School of Medicine also are nationally recognized, with U.S. News & World Report consistently ranking the hospital and medical school among the nation's elite. This department includes the nurse manager, nurse practitioner, one LPN, and a group of nurse coordinators who work together to accomplish coordination of patient care with multiple other departments and the infusion center. The nurse coordinators work hand in hand with their physician and patient/family to ensure appropriate care is coordinated before, during, and after their treatment. Job functions include scheduling of appointments and treatments, telephone triage, patient and family education, and numerous other responsibilities.


    Overview


    Role Purpose

    Works in coordination with other departmental and hospital staff to ensure reimbursement for care rendered by facility including pre-certification with external and on-site reviewers for tests and procedures. Responsible for completing the necessary data elements in a timely and efficient manner in order to financially clear all patients prior to their scheduled visit and all inpatient encounters.


    Responsibilities

  • Authorizations (inpatient, ancillary and surgery): Contacts provider offices, payors and/or payor websites to secure and validate authorization information. A review of medical records may be required if initiating the authorization request directly with a payor. Follow up on post review of insurance
    mismatch.
  • Complete quality review of all inpatient encounters to
    ensure financial clearance to avoid reimbursement delays.
  • Collaborates with case management department and third party payors to ensure timely notification of inpatient encounters.
  • Utilize payor logs and various reports to ensure all authorization documentation is accurate and complete for financial clearance. Provides additional follow-up and coordination between case management and payors to obtain clinical information to finalize authorization.

  • Minimum Requirements

     

    Degree

  • High School Diploma or GED
  •  

    Experience

  • 2-5 years
  •  

    Supervisor Experience

  • No Experience

  •  

    Preferred Requirements and Additional Job Information

     

    Degree

  • Bachelor's Degree
  •  


    Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer