Pre-certification Coordinator 1

Job Description:

The Revenue Cycle for The Ohio State University Wexner Medical Center is responsible for providing excellent customer service while processing patient demographic and insurance information 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 the Revenue Cycle is to ensure the collection of net revenue for services rendered.

The Pre-certification Coordinator is an expert in product, process or service line area (physician appointment scheduling, OR/admission, full service scheduling; pre-registration and registration; insurance verification, and patient liability determination and communication). This position is responsible for providing consumers (clinical staff and patients) with accurate, up-to-date information regarding products, services and general procedures. Schedule return appointments and/or other appointments as assigned. 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 consumer 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. Communicates regularly with clinical staff, medical secretaries and staff within the product/service line to ensure customer and department staff needs are met. Always creates a positive first impression. 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, and etc.

Minimum Qualifications For Hire:  

Required: Per CCS Class Specs: High School Diploma or GED. PC Knowledge and interpersonal, verbal, and written communication. Minimum 6 months experience in customer service or a healthcare environment.

Preferred: 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.