Pre Certification Collection Specialist

Essential Functions

• Serves as liaison between the patient, insurance company, physician, and facility.
• Confirming eligibility, benefits and precertification with insurance carriers for patients scheduled with physician and facility.
• Pre-collecting from patients including unpaid, true patient current balance, patient's estimated financial responsibility up to and including entire Out of Pocket when necessary.
• 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.
• Identifying and correcting internal problems within assigned accounts to expedite payments from insurance companies.
• Using online tools for benefits, reviewing medical criteria/policy, prior plan approval (PPA) requirements, initiating and obtaining authorizations.

Skills

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

Qualifications

• Knowledge of physician, facility and hospital pre-certification.

Skills & Abilities

• Customer Service
• Data Entry
• Documentations
• Office Management
• Patient Account Management
• Patient Care
• Payment Analysis

Education & Certifications

• N/A

Language

• N/A