Hybrid Pre-Certification Collections Specialist

OrthoCarolina; Santa Fe (NM); Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Paid holidays

Wellness programs

Tuition reimbursement

Job summary

OrthoCarolina in Charlotte is seeking a Pre-Certification Collection Specialist to join our Utilization Review team. This role is a hybrid schedule with rotating days in the office depending on department needs.

You will serve as a liaison between the patient, insurance company, physician, and facility, handling a high volume of calls and performing pre-certification, eligibility checks, and patient balance collections.

Qualifications

• Education: High School or GED is required.
• Associate or Bachelor's degree preferred.
• Minimum of one year's experience in insurance verification and authorizations.
• Must have knowledge of physician, facility and hospital pre-certification.

Responsibilities

• Confirm eligibility, benefits and precertification with insurance carriers for patient's scheduled with Physician and facility.
• 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.
• Track 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.
• Identify and correct internal problems within assigned accounts to expedite payments from insurance companies.
• Use online tools for benefits, reviewing medical criteria/policy, prior plan approval (PPA) requirements, initiating and obtaining authorizations

Skills

Accounts Receivable

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 Collection Specialist to join our Utilization Review team. This role is a hybrid schedule with rotating days in the office depending on department needs.

You will serve as a liaison between the patient, insurance company, physician, and facility, handling a high volume of calls and performing pre-certification, eligibility checks, and patient balance collections.