Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Tennessee, with more than 35 locations across the state. Our commitment to Trust, Respect, Honesty, Teamwork, Communication, Diversity, and Accountability guides how we work and how we care for our patients and communities.
Who we are defines how we care:
- Culture: A shared commitment to Trust, Respect, Honesty, Teamwork, Communication, Diversity, and taking accountability for our own actions with the belief that every one of us makes a difference.
- Patient Access: Setting the standard for orthopedic care in Tennessee with access to over 35 locations across the state, including Ambulatory Surgery Centers.
- Patient Experience: Building strong and authentic relationships with our patients and communities by unifying through consistent collaboration to deliver exceptional patient experiences.
- Financial Stewardship: Using sound judgement to make responsible financial decisions; minimizing waste and maximizing value.
Responsibilities
- Utilizes the Workflow Daily Appointment Report for your site as a primary source for insurance verification and determining insurance compatibility with TOA’s managed care plans.
- Adhere to best practices standards in performing day-to-day follow-up tasks.This includes following procedures outlined in the “VOI Training/Procedure Manual”.
- Place phone calls to patients, patient’s family/significant other, insurance companies, and facility personnel in an attempt to acquire information necessary to verify.
- Responsible to resolves any issues with coverage, referrals, precertification and escalate complicated issues to the immediate manager.Also must have a basic knowledge and understanding of what a referral and an authorization are.
- Enters and ensures information in the insurance fields is correct to its entirety.If incorrect, information in the system must be updated appropriately. This includes moving any VOB’S, authorizations and clinical referrals.If encounters were billed incorrectly to a now corrected insurance, you must email COLLECTIONS so claims can be rebilled if needed.
- Familiar with a variety of the facility concepts, practices, and procedures. Relies on experience and judgment to plan and accomplish goals.
Requirements
- High school diploma required
- 2-4 years of experience in insurance verification preferable.
- Must have experience reading and understanding payer eligibility electronic returns.Includes the ability to differentiate between insurance plans, copay, deductible, and coinsurance (patient responsibility).
- Must be able to meet average expectations for daily site verifications.
- Requires accuracy, attention to detail, ability to follow directions, organize and prioritize day-to-day tasks in order to keep work flow current
TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers