Pre-Certification Collection Specialist- Charlotte, NC

OrthoCarolina; Charlotte (NC); Hybrid; USD 25.000 - 39.000; Vollzeit

Zusammenfassung

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

Qualifikationen

• 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.

Aufgaben

• 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.

Kenntnisse

Accounts Receivable (AR)

Customer Service

Data Entry

Documentation

Medical Services

Office Management

Patient Account Management

Patient Care

Payment Analysis

Ausbildung

High School or GED

Associate or Bachelor's degree preferred

Jobbeschreibung

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. Our employees are eligible for a full spectrum of benefits including paid company holidays, wellness programs, and tuition reimbursement. To learn more about Team OC please visit https://www.orthocarolina.com/about-us

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.Other duties include:

Essential Functions:

• 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

Skills and Abilities:

• Must have knowledge of physician, facility and hospital pre-certification.

Qualifications:

• Education: High School or GED, required.Associate or Bachelors degree preferred.
• Minimum of one year’s experience in insurance verification and authorizations.

Employee Type

Regular

Skills

Accounts Receivable (AR), Customer Service, Data Entry, Documentations, Medical Services, Office Management, Patient Account Management, Patient Care, Payment Analysis

Work Experience

Healthcare Experience