What are the responsibilities and job description for the Pre-Certification Coordinator position at Tennessee Orthopaedic Alliance, PA?
Description
This position is a full-time, permanent onsite non-clinical position within Tennessee Orthopaedic Alliance in Columbia, TN.
Responsibilities
- Promptly identify any errors or other issues in precert and test/surgery scheduling.
- Communicate with insurance payer representatives, patients, and employees to ensure timely and accurate surgery schedule. This would include Commercial plans, Medicare/Medicare HMO plans, Medicaid/Medicaid HMO plans, and BCBSTN, etc.
- Operate within established guidelines and protocols, including providing backup documentation such as office notes, test reports, etc. to carriers.
- Obtains pre-certification/preauthorization from insurance companies prior to test or procedure
- Manages patient insurance verification by utilizing multiple insurance websites, phone, fax, and other methods as needed
- Timely follow up on all submitted verifications/pre-certifications
- Notifies the physician regarding denials, and approvals, etc.
Requirements
- Understanding of CPT and ICD-10 coding
- Prior Precert experience
- Knowledge of administrative and clerical procedures experience with an EHR or NextGen is a plus
- Knowledge of Insurance – particularly coordination of benefit rules and precertification denial overturns are essential to this position.
- Strong organizational and interpersonal skills
- Understanding medical terminology
Benefits
- Competitive pay
- Comprehensive benefits package including medical, dental, vision, 401k match with employee contribution and discretionary profit-sharing
- Paid Time Off (which increases with years of service)
- Paid Holidays
TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers. TOA adheres to HIPAA and OSHA safety guidelines.