What are the responsibilities and job description for the Utilization Review Collection Specialist position at OrthoCarolina?
At OrthoCarolina, our team is our greatest asset and the foundation of our success; we share a common passion for making lives better. We are a diverse group of individuals, accountable to each other through the backbone of our beliefs: trust, honesty and mutual respect; ensuring our voice is heard. Our positive environment supports individual growth and a sense of belonging. Our employees work together to uphold the standards of excellence and promote and environment of teamwork throughout the organization.
If these attributes align with the job culture you are seeking - then OrthoCarolina might be the right fit for you!
We are currently searching for a Pre-Certification Collection Specialist to join our Utilization Review team in the OrthoCarolina Business Office in Charlotte .
The Pre-Certification Collections Specialist serves as liaison between patient, insurance company, physician and facility. There is a large volume calling patients and insurance companies. Other duties include:
- Confirming eligibility, benefits and precertification with insurance carriers for patient's scheduled with Physician and facility.
- Must have knowledge of physician, facility and hospital pre-certing.
- 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 to 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.
- Responsible to identify and correct 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
A career at OrthoCarolina will provide you with opportunities for career advancement, dedicated peer support, and continuing education. Our company is committed to providing our employees with the utmost positive work environment. Benefits offered include:
- Competitive salary package
- Health, Dental, and Vision insurance
- Health Savings Account
- Life insurance
- Short/Long term disability insurance
- Tuition Reimbursement
- Voluntary Home/Auto insurance
- Voluntary Accident/Cancer insurance
- Voluntary Legal Shield/Identity Theft
- Health Advocate – Employee Benefit Resource
- 401(k) retirement plan
- Profit sharing plan
OrthoCarolina is one of the nation’s leading independent academic orthopedics practices serving North and South Carolina and the Southeast since 1922. OrthoCarolina provides compassionate and comprehensive musculoskeletal care including operative and non-operative care, diagnostic imaging and rehabilitative therapy. Widely known for musculoskeletal research and training, OrthoCarolina physicians have specialized expertise in foot and ankle, hip and knee, shoulder and elbow, spine, sports medicine, hand, pediatric orthopedics, and physical medicine and rehabilitation. We commit to improving the lives of all we serve, by providing premier patient care and compassionate, personalized service. Over 300 OrthoCarolina providers see more than one million patient visits throughout western North Carolina each year.
OrthoCarolina. You. Improved.
Employee Type
RegularQualifications
Skills
Education
A.A (Required), A.S (Required), B.A., B.S.Certifications
Language
Work Experience
Healthcare Experience