THS+

Clinical Assistant

• Providing and coordinating orthopedic patient care.
• Performing routine office procedures and testing.
• Participating in patient teaching.
• Communicating effectively with others.
• Partnering with the physician/mid-level provider in the delivery of patient care.
• Updating clinical notes in electronic medical systems.
• Completing phone triage.
• Casting and bracing.
• Providing patient education.

Clinical Assistant, RMA, CMA, LPN, ATC, EMT

General

• Receiving all OrthoCarolina claim denials for services not authorized for Surgery
• Familiarity with all areas of EMR (clinical, UR, transactions)
• Investigating documentation for all departments
• Understanding the authorization process, medical criteria, denials, and appeals
• Liaison between Payor, AR Department, Coding Department, and UR Department for all claim denials related to services not authorized
• Knowledge of claims processing, ability to verify eligibility and benefits.

UR Pre-Certification Specialist – Hospital Pickup and Denials

• Greets patients
• Prepares forms
• Collects, verifies, and enters patient information into EPIC
• Answers incoming phone calls and directs calls
• Makes appointments
• Performs Cashier duties as directed including posting of charges
• Collection of co-payments/co-insurance and balances due
• Follows the process for release of medical information and FMLA/disability forms completion as requested

Patient Services Specialist

Customer Support

• Courteously answering and routing business office patient account phone calls
• Assist patients with account questions
• Processing electronic insurance claims
• Generating and analyzing custom claims reports
• Processing insurance claims for secondary payers and credit card transactions

Clinical Assistant, RMA, CMA, LPN, ATC, EMT

UR Pre-Certification Specialist – Hospital Pickup and Denials

Patient Services Specialist

Customer Support Representative, Medical Billing