Who We Are

Tennessee Retina is the largest Ophthalmology practice in middle Tennessee offering rewarding careers across 8 locations. We are committed to providing the highest level of care to our patients in the most convenient and caring manner. Our physicians are leaders in the research and application of new retina, macula, and vitreous treatments.

We are seeking an energetic and collaborative Insurance Follow-up/ Denials Specialist. The ideal candidate is responsible for performing day-to-day billing and follow-up on outstanding accounts receivable. Day-to-day activities may include all or some of the essential functions listed below depending upon individual experience/ knowledge and the needs of the organization which are subject to change from time to time.

This exciting opportunity will work closely and be supported by a team of colleagues, strong leadership, and cutting-edge technology! A day in the life of a Tennessee Retina employee is filled with learning, growing, creating, hard work, and, most of all fun!

Tennessee Retina offers a competitive salary based on diverse experiences and backgrounds.

Benefits Offered

• Sign On Bonus, Certification Incentive Bonus, and Length of Service Award Bonus Programs
• Continuing Education Program
• Transportation Reimbursement Program
• Employer-sponsored Medical, Dental, Vision, Critical Illness Coverage, Short-term, Long-Term Disability, & Employee Assistance Program
• 401(k) with Generous Employer Match
• Health Savings Account (HAS) and Flexible Spending Benefits
• Paid Holidays and Paid Vacation
• Annual Scrub Uniform Allowance
• Employee Referral Award Bonus Program
• Succession, Growth, and Mentorship Opportunities

• Social Gathering and Team Opportunities
• Full new hire training program to fully support, train, and welcome new hires to the team

Responsibilities

• Utilizes the practice management system to perform follow-up on assigned outstanding accounts receivables. Receivables may include balances due from insurance and patient balances.
• Place phone calls to payers and/or utilize payer websites to resolve aged outstanding balance.
• Prepares and submits reconsiderations, appeals, medical record documentation request and correct claims as needed to ensure timely follow-up with all claims.
• Research denials and denial trends and notify Supervisor or Billing Manager when a trend is discovered offering account specific examples.
• Reviews all appropriate billing worklists as assigned within practice management system including zero pay denials, overpayments, fully worked receivables, holds, and manager holds.
• Researches, identifies, and rectifies any special circumstances resulting in delayed payments.
• Adhere to best practices standards in performing day-to-day follow-up tasks.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

Education, Training, and Experience

• High School Diploma or GED
• Minimum of 1 year of experience handling physician accounts receivable duties.
• Prefer candidates that are proficient in NextGen practice management system.
• Must have experience Preferred experience and knowledge reading and understanding of payer benefits. This includes differentiating between allowed charges, contractual adjustments, line-item denials/reasons, patient responsibility (co-pay, co-insurance, and deductibles), bundled payments, and understanding payer medical policy guidelines and protocols while utilizing these guidelines to manage authorizations effectively.
• Must be able to meet average expectations for productivity and quality standards.
• Prefer candidates that are proficient in utilizing MS-Excel for analyzing data using basic formulas, pivot tables, and charts.

• Effective verbal and written communication skills with patients, physicians, management, employees, and the public.
• Excellent Organizational skills, multi-task, and logical thinking
• Knowledge of Microsoft Office (Word, Outlook) and the ability to learn and adapt quickly to new software.
• Ability to be proactive, take initiative, and perform well in a fast-paced, high-volume practice.

Confidentiality

Maintains strict confidentiality regarding protected health information (PHI) and understands and adheres to TNR’s HIPAA privacy and security policies and procedures.

Typical Physical and Working Demands

Position requires prolonged walking, sitting, some bending, stooping, and stretching. Good eye-hand coordination and manual dexterity are sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is required. Employees must have a normal range of hearing and eyesight to record, prepare, and communicate appropriate reports. Employees must have a normal range of hearing and eyesight to record and prepare paper and MDI chart notes and documents. Must be able to lift and carry up to 15 pounds.