Job Description

Location

Remote, US

Scheduled Hours

40

Position Summary

The Pre-Arrival Team Lead coordinates daily assignments to ensure the team’s ability to complete high volumes in a timely manner. Responsible for team’s accuracy of registration and insurance plan/FSC information of patient accounts. Additionally, the Pre-Arrival Lead coordinates the workload and processes for obtaining procedure authorizations and referrals. Acts as a resource to staff in their team and others. This position requires heavy call volume to insurance companies, third party administrators, physician offices, and employers to verify eligibility, obtain referrals and authorizations, and to obtain specific benefit information pertaining to oncology visits.

Job Description

Primary Duties & Responsibilities:

Lead your assigned teams- Eligibility, Benefits or Referral, in daily activities and the prioritization of tasks. Assist in adjusting assignments based on coverage needs of the entire unit.

Work daily assignments in the Eligibility, Benefits and Referrals, which include, but not limited to:

• Work eligibility and/or referral pre-arrival alerts in Alerts Manager.
• Coordinate, obtain and accurately document and communicate referrals and authorizations.
• Accurately convert Generic Plans into P plans on daily basis.
• Accurately assign a FSC/Plan or ascertain integrity of existing plan/FSC.
• Contact Payer/ TPA by phone regarding eligibility.
• Contact Payer/TPA by phone to complete a worksheet for benefits pertaining to Oncology visits/treatments.
• Contact patients when necessary to discuss self-pay status, non-contracted plans and financial options. Refer patients to financial counselors.
• Access BJH system and various web sites for insurance/eligibility information.
• Identify registration issues related to visits and invoices.

Support clinical areas for questions regarding registration, benefit and referrals. Send financial alerts and notifications to inform Divisions of potential financial liability.

Manage TES and ETM files as assigned by manager. Update invoices and redirect claims to appropriate payers when appropriate.

Send financial alerts/notification to Divisions to advise of potential financial liability.

Provide education and training to staff.

Provide feedback to management regarding staffing concerns and process improvement.

Other duties as assigned by manager.

Working Conditions:

Job Location/Working Conditions

• Normal office environment.

Physical Effort

• Typically sitting at desk or table.
• Occasional lifting (25 lbs or less).

Equipment

• Office equipment.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.

Required Qualifications

Education:

High school diploma or equivalent high school certification or combination of education and/or experience.

Certifications/Professional Licenses:

No specific certification/professional license is required for this position.

Work Experience:

Medical Billing/Coding (3 Years)

Skills:

Not Applicable

Driver's License:

A driver's license is not required for this position.

More About This Job

Required Qualifications

• Previous pre-certification experience.

Preferred Qualifications

• Some college or associate degree.
• Coding experience preferred.
• Applicant must have a thorough understanding of both Washington University FSC database and insurance terminology.
• Experience interacting with managed care plans, insurance companies and third-party payers.
• Ability to work with internal and external customers, including physicians, nurses, patients and families.

Preferred Qualifications

Education:

Associate degree

Certifications/Professional Licenses:

Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)

Work Experience:

No additional work experience unless stated elsewhere in the job posting.

Skills:

Communication, Detail-Oriented, Fast-Paced Environments, Insurance Terminology, Interpersonal Communication, Medical Billing and Coding, Multitasking, Organizational Savvy, Prioritization

Grade

C09-H

Salary Range

$23.63 - $35.49 / Hourly

The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

Questions

For frequently asked questions about the application process, please refer to our External Applicant FAQ.

Accommodation

If you are unable to use our online application system and would like an accommodation, please email CandidateQuestions@wustl.edu or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.

All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.

Pre-Employment Screening

All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.

Benefits Statement

Personal

• Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Take advantage of our free Metro transit U-Pass for eligible employees.
• WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.

Wellness

• Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!

Family

• We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.
• WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.

For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/

EEO Statement

Washington University in St. Louis is committed to the principles and practices of equal employment opportunity. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity or shared ancestry, color, national origin, citizenship (where prohibited by federal law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information. As a federal contractor, the university maintains affirmative action programs to implement its equal employment opportunity policy for individuals with disabilities and protected veterans, in accordance with Section 503 of the Rehabilitation Act of 1973, as amended, and the Vietnam Era Veterans’ Readjustment Assistance Act of 1974 (VEVRAA), as amended.