Therapy Autho Coordinator

TOA Middle•Clarksville, TN

33d•Onsite

About The Position

Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Nashville and Middle Tennessee, focusing on the diagnosis and treatment of disorders and injuries of the musculoskeletal system. With a history dating back to 1926 and nearly 20 locations, TOA offers stability and the opportunity to make a positive impact in the community. TOA fosters an excellent working environment characterized by positivity, collaboration, job satisfaction, and engagement. The organization provides competitive salaries and a comprehensive benefits package, including Medical, Dental, Paid Time Off, and a 401(k) plan with company match, safe harbor match, and profit sharing.

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

Nice To Haves

basic knowledge and understanding of what a referral and an authorization are

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.
Adheres to best practices standards in performing day-to-day follow-up tasks, including following procedures outlined in the “VOI Training/Procedure Manual”.
Places phone calls to patients, patient’s family/significant other, insurance companies, and facility personnel in an attempt to acquire information necessary to verify.
Resolves any issues with coverage, referrals, precertification and escalates complicated issues to the immediate manager.
Enters and ensures information in the insurance fields is correct to its entirety. If incorrect, information in the system must be updated appropriately.
Moves any VOB’S, authorizations and clinical referrals.
Emails COLLECTIONS so claims can be rebilled if needed if encounters were billed incorrectly to a now corrected insurance.