Pre Certification Collection Specialist

OrthoCarolina•Charlotte, NC

4d•Hybrid

About The Position

At OrthoCarolina, our team is our greatest asset and the foundation of our success. We are a diverse group of individuals, accountable to each other to uphold the standards of excellence and promote an environment of teamwork throughout the organization. OrthoCarolina has 43 unique care locations with over 1300 professionals who share a common goal to make lives better. We are currently searching for a Pre-Certification Collection Specialist to join our Utilization Review team in the OrthoCarolina Business Office in Charlotte. This position is a hybrid schedule with rotating days in the office depending on department needs. The Pre-Certification Collections Specialist serves as liaison between the patient, insurance company, physician, and facility. There is a large volume calling patients and insurance companies.

Requirements

Must have knowledge of physician, facility and hospital pre-certification.
Accounts Receivable (AR)
Customer Service
Data Entry
Documentations
Office Management
Patient Account Management
Patient Care
Payment Analysis

Responsibilities

Confirming eligibility, benefits and precertification with insurance carriers for patient's scheduled with Physician and facility.
Responsible to pre-collect from patients including unpaid, true patient current balance, patient's estimated financial responsibility up to and including entire Out of Pocket when necessary.
Responsible for tracking the account from notification of scheduled appointment including same day and next day add-ons for authorization as well as pre-collection of patient financial responsibility.
Responsible for identifying and correcting internal problems within assigned accounts to expedite payments from insurance companies.
Responsible for using online tools for benefits, reviewing medical criteria/policy, prior plan approval (PPA) requirements, initiating and obtaining authorizations