AtOrthoCarolina, 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. OrthoCarolinahas 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 foraPre-Certification Collection SpecialisttojoinourUtilization ReviewteamintheOrthoCarolinaBusiness Office in Charlotte

This position is a hybrid schedule with rotating days in the office depending on department needs.

The Pre-Certification Collections Specialistserves asliaisonbetweenthe patient, insurance company, physician,and facility.  There is a large volume calling patients and insurance companies. Other duties include:

Essential Functions:

• Confirming eligibility,benefitsand 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 estimatedfinancial responsibilityup to and including entire Out of Pocket when necessary. 

• Responsiblefor trackingthe account from notification of scheduled appointment including same day and next day add-ons for authorization as well as pre-collection of patientfinancial responsibility 

• Responsibleforidentifyingandcorrectinginternal problems within assigned accounts toexpeditepayments from insurance companies. 

• Responsible for using online tools for benefits, reviewing medical criteria/policy, prior plan approval (PPA) requirements,initiatingand obtaining authorizations

Skills and Abilities:

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