Certified Surgical Technologist- Matthews Surgery Center
ths
Full time
UR Pre-certification and Denials Specialist- Hybrid Schedule
ths· OrthoCarolina
About this role
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
OrthoCarolina is looking for a UR Pre-Certification Specialist- Hospital Pickup and Denials for our OrthoCarolina Business Office location in Charlotte. This position is a hybrid schedule with rotating days in the office depending on department needs.
The UR Pre-Certification Specialist- Hospital Pickup and Denials is responsible for receiving all OrthoCarolina claim denials for services not authorized for Therapy, MRI, Radiology, Surgery, Physiatry, DME, Hospital E&M, and high dollar injections. This role is required to be familiar with all areas of EMR (clinical, UR, transactions) and investigating documentation for all departments.
Essential Functions:
- Completely understanding the authorization process, medical criteria, denials, and appeals and will serve as a liaison between Payor, AR Department, Coding Department, and UR Department for all claim denials related to services not authorized.
- Must have knowledge of claims processing as well as the ability to verify eligibility and benefits and obtain any required authorization for all UR Departments.
Employee Type
RegularQualifications
Skills
Authorizations, Claims Processing, Health Insurance Verification, Insurance Authorizations, Insurance Eligibility Verification, Insurance Verification, Medical Billing and Coding, Medical KnowledgeEducation
Certifications
Language
Work Experience
Frequently Asked Questions
Is the salary disclosed for the UR Pre-certification and Denials Specialist- Hybrid Schedule position at ths?
The salary for this UR Pre-certification and Denials Specialist- Hybrid Schedule role at ths is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the UR Pre-certification and Denials Specialist- Hybrid Schedule position at ths located?
This UR Pre-certification and Denials Specialist- Hybrid Schedule role at ths is based in Charlotte, NC. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the UR Pre-certification and Denials Specialist- Hybrid Schedule role at ths full-time or part-time?
This is listed as a Full time position. It is posted as a UR Pre-certification and Denials Specialist- Hybrid Schedule role in the OrthoCarolina department at ths.
Which team or department does the UR Pre-certification and Denials Specialist- Hybrid Schedule at ths belong to?
This UR Pre-certification and Denials Specialist- Hybrid Schedule position is part of the OrthoCarolina department at ths. See the full job description for more information about the team structure and responsibilities.
How do I apply for the UR Pre-certification and Denials Specialist- Hybrid Schedule position at ths?
Click the "Apply Now" button on this page. You will be redirected to ths's official application portal hosted on workday where you can submit your application directly.
UR Pre-certification and Denials Specialist- Hybrid Schedule
ths
You'll be redirected to ths's official application page on Workday.