Health Information Specialist - Department of Pediatrics/Medical Genetics - West Virginia University Research Corporation

West Virginia University Research Corporation is currently accepting applications for a Health Information Specialist in the Department of Pediatrics/Medical Genetics

About the Opportunity

This position provides insurance prior authorization support to the Medical Genetics Section of the Department of Pediatrics including administrative tasks, educational and research activities of the program in accordance with specific objectives. This position provides program, as well as direct internal and external client support services. Responds to inquiries and independently resolves matters of low complexity. Responsibilities require some judgment, resourcefulness and originality, but diverse guides and precedents are usually available to apply or adapt to the circumstances. Work effort has considerable impact on client services, program and project image, with potential legal liabilities.  

At WVU Research Corporation, we strongly believe in work-life balance and keeping time for things we love outside our work. WVU Research Corporation offers a comprehensive benefits package with a variety of options to suit your needs:
• 13 paid holidays (staff holiday calendar)
• PTO
• 403(b) retirement savings with a fully vested 3% employee contribution match, (Employees have the option of contributing an additional 1-3% of their earnings to the plan, which is also matched by the WVURC)
• A range of health insurance and various other benefits
• Dependent Education Scholarship
• WVU Perks
• And More!!

What you’ll do:

• Contacts insurance companies to determine eligibility, benefits, and authorization for requested genetic testing.
• Provide all relevant clinical information, ICD-10 codes, and CPT codes to obtain necessity of prior-authorization and necessary paperwork to insurance and lab.
  
• Document referrals/authorization/certification numbers in the registration/scheduling systems plus info in genetic spreadsheet.
  
• Maintain current knowledge of major insurance policies, practices, and requirements regarding all relevant procedures.
  
• Perform follow-up and assists with denial management issues through written communication, phone calls, or by facilitating peer-to-peer reviews between physicians.
  
• Receive incoming calls, email correspondence, ensure that accurate and timely communication is facilitated and patient satisfaction is high.
  
• Provide excellent and caring customer service to patients, visitors and employees.
• Will schedule patient appointments in Epic for Morgantown and outreach sites.
• Provides back up to department secretary in her absence.
  
• Duties shall not be limited to these activities but shall also include other activities as assigned by the Program Assistant III or the Division Chief of Medical Genetics.
• Participate in the continuing educational activities of the program by helping coordinate or presenting educational programs to groups as outlined by supervisor. 

• High School diploma or equivalent required. Associate’s Degree in an allied health field preferred.
• A minimum of six (6) months of experience in medical coding and insurance.
• Knowledge of ICD-10 and CPT coding requirements.
• Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
• Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
• Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
• Skilled at using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Skilled at talking to others to convey information effectively.
• Skilled at communicating effectively in writing as appropriate for the needs of the audience.
• The ability to apply general rules to specific problems to produce answers that make sense.
• The ability to listen to and understand information and ideas presented through spoken words and sentences. 

The WVURC was created as a not-for-profit corporation in 1985 to support research (R1) at West Virginia University. We provide evaluation, development, patenting, management, and marketing services for inventions of the faculty, staff and students of the University.

The WVURC receives and administers funds awarded by external agencies for research and other activities and is responsible for helping protect intellectual property through patents, copyrights and licensing agreements for start-up companies based on University research.

Creating an inclusive, engaged, and dynamic environment is core to WVURC’s mission. We welcome candidates who can contribute a range of ideas, approaches and experiences.

West Virginia University Research Corporation is proud to be an Equal Opportunity employer. We value diversity among its employees and invites applications from all qualified applicants regardless of race, ethnicity, color, religion, gender identity, sexual orientation, age, nationality, genetics, disability, or Veteran status.  

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