Pre - Certification Coordinator II

WashU IT

Pre-Certification Coordinator II responsible for handling pre-certifications for specialized medicine services. Analyzing therapy plans and verifying insurance eligibility for optimal treatment outcomes.

Posted 6/30/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $23 - $34 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in pre-certification processes, including authorization and insurance eligibility verification, while effectively collaborating with clinical staff and providers to resolve issues. Proficient in utilizing Epic EHR and knowledgeable in HIPAA regulations and insurance terminology.

Highest-signal resume keywords

Pre-Certification ExperienceEpic EHR ProficiencyInsurance Claim ProcessingHIPAA KnowledgeDetail-Oriented Communication

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Pre-CertificationAuthorization ProcessInsurance Eligibility VerificationClinical Documentation AnalysisInsurance Terminology

Soft Skills

Communication SkillsDetail-Oriented

Tools & Technologies

Epic EHRInsurance Claim Processing Software

Certifications & Qualifications

High School Diploma

Industry Keywords

Health Information ManagementMedical BillingPayer PoliciesPatient BenefitsDenials and Appeals

About the role

Key responsibilities & impact

Completes pre-certifications for complex and specialized services as indicated on therapy and treatment plans
Reads and analyzes therapy and treatment plans, drug protocols, and clinical documentation, as well as payer policies and patient benefits
Completes the authorization process with the payer and in EPIC
Completes rechecks on existing pre-certifications by verifying insurance eligibility and all authorization information for all applicable services
Confirms all recheck information is documented in EPIC
Works with clinical staff and providers on add-ons, denials and peer to peers through to resolution
Performs other duties as assigned, such as assistance with denials, rejections and appeals

Requirements

What you’ll need

High school diploma or equivalent high school certification or combination of education and/or experience
3 years experience in Clinical Office, Medical Billing, Health Information Management (HIM), or Pre-Certification
Communication skills
Detail-Oriented
Experience with Epic EHR
Knowledge of Health Insurance Portability & Accountability Act (HIPAA)
Familiarity with Insurance Claim Processing Software
Understanding of Insurance Precertification and Insurance Terminology

Benefits

Comp & perks

Up to 22 days of vacation
10 recognized holidays
Sick time
Competitive health insurance packages with priority appointments and lower copays/coinsurance
Free Metro transit U-Pass for eligible employees
Defined contribution (403(b)) Retirement Savings Plan
Wellness challenges
Annual health screenings
Mental health resources
Mindfulness programs and courses
Employee assistance program (EAP)
Financial resources
Access to dietitians
4 weeks of caregiver leave to bond with your new child
Family care resources for continued childcare needs
Tuition coverage for you and your family