Hybrid Pre-Certification Collections Specialist

OrthoCarolina; Charlotte (NC); Hybrid; USD 42,000 - 62,000; Full time

Job summary

OrthoCarolina in Charlotte, NC is seeking a Pre-Certification Collections Specialist to join the Utilization Review team. This regular, full-time position offers a hybrid schedule with rotating in-office days depending on department needs.

The role focuses on coordinating between patients, insurers, physicians, and facilities to verify eligibility and collect the patient financial responsibility. Strong knowledge of pre-certification processes is required.

Qualifications

• Must have knowledge of physician, facility and hospital pre-certification.
• Experience in accounts receivable or patient financial responsibilities is helpful.
• Ability to navigate insurance processes and patient communications.

Responsibilities

• Confirming eligibility, benefits and precertification with insurance carriers for patients scheduled with physician and facility.
• Pre-collect from patients including unpaid balances and estimated financial responsibility.
• Track accounts from notification of scheduled appointments including same day/next day add-ons for authorization and pre-collection.
• Identify and correct internal problems within accounts to expedite payments from insurance companies.
• Use online tools for benefits, policy review, prior authorization requirements, initiating and obtaining authorizations.

Skills

Pre-certification knowledge

Job description

OrthoCarolina in Charlotte, NC is seeking a Pre-Certification Collections Specialist to join the Utilization Review team. This regular, full-time position offers a hybrid schedule with rotating in-office days depending on department needs.

The role focuses on coordinating between patients, insurers, physicians, and facilities to verify eligibility and collect the patient financial responsibility. Strong knowledge of pre-certification processes is required.