Precertification Financial Collections Specialist (47172)

Primary Objective

The Precertification and Financial Collection Specialist plays a critical role in healthcare administration by ensuring that financial collections are conducted efficiently and professionally. This position requires close coordination with providers, patients, and pre-cert teams to confirm coverage and secure payment prior to services being rendered. 

Essential Functions

• Communicate with patients regarding their financial obligations and provide guidance on payment options. 

• Coordinate with billing and clinical staff to ensure accurate documentation and timely collections. 

• Communicating with providers office when patient is not able to meet financial obligation for guidance. 
• Work and Maintain Good Faith estimate work queue

• Provide backup for team members as needed to assist with referral backlogs 

Skills and Abilities

• Strong attention to detail and organizational skills.

• Excellent communication and customer service abilities.

• Knowledge of insurance guidelines, medical terminology, and billing procedures.

• Proficiency with healthcare management software (EPIC) preferred

• Ability to work independently and collaboratively in a fast-paced environment.

Core Competencies

• Attention to Detail
• Multi-Tasking & Adaptability
• Critical Thinking
• Follow up

Clinical Competencies

N/A

Training Period

90 days of training within Epic

Accountability

Our mission is to be the premier eye, ear, nose, and throat group providing comprehensive, quality, and ethical healthcare to all in the Carolinas; to provide a favorable environment for the delivery of healthcare; and to provide for the wellbeing of the physicians and the employees of Charlotte Eye Ear Nose & Throat Associates, P.A.

Work Environment

The work environment characteristics described are representative of those an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work is remote, so employee should have discipline to work alone and have a dedicated workspace with highspeed internet which offers HIPAA compliance and room for two monitors.

Supervisory Responsibilities

N/A

Position Type and Expected Hours of Work

Full-time 40-hour weekly position. The hours may range between 7:00a.m. and 6:00p.m.

Physical, Mental and Other Requirements

The physical and mental demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands: Sitting and working on a computer for extended periods of time. Ability to wear a headset for telephone usage and team meetings 

Mental Demands: Ability to work alone, problem solve and work at a high pace.

Other Requirements:  

• Active & Current Driver’s license  
• Clean driving record  
• Consistent and Reliable Transportation  
• Polite and professional disposition  

Travel

Travel is not required for this position, except when training or occasional in-person staff meetings

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. In addition to those essential functions identified above, individuals in this position are also responsible for performing other duties or tasks that may be assigned. CEENTA retains the discretion to add or change the essential job functions of this position at any time without notice.

A Typical Day in the Position

The Precertification Specialist is responsible for obtaining prior authorizations for all scheduled surgical, DME, allergy, V&S, and radiology orders by successfully completing the approved authorization process for all payers. Typical responsibilities include but are not limited to: monitoring assigned work queues, contacting payers, contacting patients about any pre-service payments, address emails/in-baskets, address voicemails, scanned faxes, communicating as needed with provider offices. The Pre-certification specialist should be able to work independently and solve routine type issues, but when potential systemic issues are noted, these should be reported to the Precertification Team Supervisor.