Utilization Review Specialist MRI (Hybrid Schedule)

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 MRI Precertification Collections Specialist to join our Utilization Review Support 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 UR Precertification Collections Specialist confirms the eligibility, benefits, precertification and pre-collect for all commercial and self-pay patients.  Pre-collections will include unpaid, true patient current balance, and patient's estimated financial responsibility for procedures.  Identifies and corrects internal problems within assigned accounts to expedite payments from insurance companies.  This position serves as liaison between patient, insurance company, physician, and facility.  The position involves a large volume calling patients and insurance companies.  

Essential Functions: 

• Works off daily report of scheduled MRI procedures. 

• Verifies insurance and benefits for scheduled procedures. 

• Obtains insurance authorization when needed. 

• Calculates the patient’s portion at contracted rate using benefits provided by the insurance company. 

• Communicates with patient regarding their benefits and the estimated patient portion due for procedure including outstanding balances. 

• Ensures information in practice management system is correct.