PreCertification Coordinator

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.