Description

Tennessee Orthopaedic Clinics is one of the nation’s largest orthopedic networks. TOC offers comprehensive medical and surgical treatment of bone, joint and soft tissue disorders. Our treatment is compassionate, conservative, and prompt, providing patients with the specialized orthopedic care they deserve. 

 There are numerous reasons why TOC is an employer of choice; here are a few of them:

· Stability and Growth – TOC promotes long-term employment in positions as well as growth opportunities for those who want to further their career goals.

· Impact - TOC’s team members use our careers – whether in our clinics or our business office – to make a positive difference in the community by building relationships and positively impacting patient lifestyles.

· Work Environment - The TOC team focuses on cultivating an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement.

· Total Rewards - TOC offers competitive salaries based on the current East Tennessee wage market, plus a comprehensive benefit package, including Medical, Dental, Paid Time Off, Extended Illness Bank and more. Our 401(k) plan provides a company match, safe harbor match and profit-sharing match to go along with your contributions.

The Centralized Referral Scheduling and Verification Specialist for PT is an important link in the TOC revenue cycle effort. The efforts of the authorization team help determine if a procedure is covered, paid, or denied. The ideal candidate will be highly organized, detail oriented, team-first mindset, self-motivation, and ability to function in a fast-paced atmosphere, can work independently and with a team.

Responsibilities include:

· Understands and interprets benefit information.

· Verifies insurance plans for physical therapy patients.

· Obtains pre-certification/preauthorization from insurance companies prior to each therapy visit.

· Manages patient insurance verification by utilizing multiple insurance websites, phone, fax, and other methods as needed.

· Submit all required documentation needed to obtain pre-certification via insurance websites and in a timely manner.

· Timely follow up on all submitted verifications/pre-certifications

· Notifies the therapy clerical team regarding denials, and approvals, etc.

· Follows processes as set forth by department manager

· Serves as liaison between patient and administration.

· Other clerical responsibilities as assigned.

Requirements

 Requirements:

· High school diploma or equivalent is required.

· At least 3 years insurance verification/pre-certification experience is preferred, with some experience in an orthopaedic practice a plus

· Exceptional customer service and patient focus.

· Knowledge of Insurance – particularly coordination of benefit rules and precertification denial overturns are essential to this position.

· Knowledge of administrative and clerical procedures, including experience with computer systems/Excel. Experience with an EHR or NextGen is a plus

· Understanding of CPT and ICD-10 coding

TOC is an equal opportunity employer. TOC conducts background checks on applicants who accept employment offers.