Hybrid Pre-Certification & Collections Specialist

OrthoCarolina; Charlotte (NC); Hybrid; USD 25,000 - 39,000; Full time

Job summary

OrthoCarolina in Charlotte is seeking a Pre-Certification Collections Specialist to join our Utilization Review team. The role acts as a liaison between patients, insurance carriers, physicians, and the facility, handling a high-volume call workload to verify eligibility and obtain approvals.

Responsibilities include pre-collection of balances and estimated patient financial responsibility, tracking accounts from scheduling through authorization, and using online tools to review benefits and

Qualifications

• Education: High School or GED required; associate or bachelor's degree preferred.
• Minimum of one year’s experience in insurance verification and authorizations.
• Knowledge of physician, facility and hospital pre-certification.

Responsibilities

• Confirm eligibility, benefits and precertification with insurance carriers.
• Pre-collect from patients including unpaid balances and estimated financial responsibility.
• Track accounts from scheduling through authorization and pre-collection.
• Identify and fix internal issues to expedite insurance payments.
• Utilize online tools for benefits, policy review, and authorizations.

Skills

Accounts Receivable (AR)

Customer Service

Data Entry

Documentation

Medical Services

Office Management

Patient Account Management

Patient Care

Payment Analysis

Education

High School or GED

Associate or Bachelor's degree preferred

Job description

OrthoCarolina in Charlotte is seeking a Pre-Certification Collections Specialist to join our Utilization Review team. The role acts as a liaison between patients, insurance carriers, physicians, and the facility, handling a high-volume call workload to verify eligibility and obtain approvals.

Responsibilities include pre-collection of balances and estimated patient financial responsibility, tracking accounts from scheduling through authorization, and using online tools to review benefits and