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OrthoCarolina

Utilization Review Collection Specialist

OrthoCarolina, Charlotte, North Carolina, United States, 28202

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locations

Charlotte, NC

time type

Full time

posted on

Posted Yesterday

job requisition id

R7087

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.

Employee Type

Regular

Qualifications

Skills

Education

A.A (Required), A.S (Required), B.A., B.S.

Certifications

Language

Work Experience

Healthcare Experience