Tennessee Orthopaedic Alliance

Description Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Nashville, Middle Tennessee and East Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: - Stability- TOA has been in Middle Tennessee since 1926! - Impact- TOA’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 helping patients live their best life. - Work Environment- The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. - Total Rewards- TOA offers competitive salaries based off the area's wage market, plus a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit sharing match to go along with your contributions. The Insurance Verification Specialist is responsible for the timely verification of medical insurance benefits. 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. - 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. - Adhere to best practices standards in performing day-to-day follow-up tasks.This includes following procedures outlined in the “VOI Training/Procedure Manual”. - Place phone calls to patients, patient’s family/significant other, insurance companies, and facility personnel in an attempt to acquire information necessary to verify. - Responsible to resolves any issues with coverage, referrals, precertification and escalate complicated issues to the immediate manager.Also must have a basic knowledge and understanding of what a referral and an authorization are. - Enters and ensures information in the insurance fields is correct to its entirety.If incorrect, information in the system must be updated appropriately. This includes moving any VOB’S, authorizations and clinical referrals.If encounters were billed incorrectly to a now corrected insurance, you must email collections so claims can be rebilled if needed. - Familiar with a variety of the facility concepts, practices, and procedures. Relies on experience and judgment to plan and accomplish goals. Requirements - High school diploma required - 2-4 years of experience in insurance verification preferred - Must have experience reading and understanding payer eligibility electronic returns, and the ability to differentiate between insurance plans, copay, deductible, and coinsurance - Requires accuracy, attention to detail, ability to follow directions, and organization skills TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers

Description *** WORK AT HOME*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on diagnosing and treating disorders and injuries of the musculoskeletal system, allowing our patients to live their best lives. Ninety-plus years later, we are advancing the practice of orthopaedic surgery throughout the state. There are several reasons why TOA is an employer of choice; here are a few of them: - Stability -TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! - Impact -TOA'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 helping patients live their best lives. - Work Environment -The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. - Total Rewards -TOA offers a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit-sharing match to go along with your contributions. JOB SUMMARY The AR Specialist is an essential part of the TOA Central Business Office. As an AR Specialist, you will use your analytical, financial, and customer service skills to ensure that TOA claims filed to an insurance payer are processed accurately and in a timely manner. DUTIES AND RESPONSIBILITIES - Promptly identify any errors or other issues in claims processing. - Effectively following up on any unpaid balances. - Expeditiously bring any remaining balance to resolution. - Meet quality assurance and productivity standards by identifying and reconciling insurance balance accounts. - Identify denial trends and provide potential solutions while analyzing patient accounts utilizing our EPM system – Nextgen to determine appropriate action. - Review explanations of benefits details on denials. - Communicate with insurance payer representatives, patients, and TOA staff to ensure timely and accurate resolution of account transactions. This would include Commercial plans, Medicare/Medicare HMO plans, Medicaid/Medicaid HMO plans, and BCBSTN. - Prioritize assigned accounts to maximize aged accounts receivable resolution. - Review the explanation of benefit (EOB) documentation and notate accounts on collection activity to perform account resolution. - Operate within established guidelines and protocols, including providing backup documentation for our accounting and audit functions. - Collaborate closely with the Central Business Office, clinical colleagues, and administrative teammates to develop a cohesive, high-performing team. - Adhere to HIPAA and OSHA safety guidelines. Requirements - Exceptional customer service and patient focus. - Knowledge of Insurance – particularly coordination of benefit rules and denial overturns are essential to this position. - Knowledge of administrative and clerical procedures. - Accustomed to using mostly payer websites for appeals/reconsiderations, medical records attachments, verification of benefits, and/or web-based claims follow-up. - Ability to communicate and work as a team. - Demonstrated proficiency with Microsoft Office programs such as Excel, Word, and Outlook. - At least 3 years insurance collections experience. - Experience using NextGen. - Orthopaedic specialty experience. - Fluency in English is required; Fluency in a second language is a plus. WORKING CONDITIONS TOA fosters an excellent working environment of positivity, collaboration, job satisfaction, and engagement. AR Specialist will be assigned to work in TOA’s Central Business Office at an assigned cubicle in a call center environment and from home occasionally. The department experiences high volume, and as a result, it has associated stressors that conflict with a fast-paced environment. The noise level in the work environment is moderate to loud, with other staff members answering phones and collaborating. Regularly sit while working on the computer; use hands and fingers to handle, control, or feel objects, too, ls commands; repeat the same movements when entering data; speak clearly so listeners can understand; understand the speech of another person; ability to differentiate between colors, shades, and brightness; read from a computer screen for extended periods time. Frequently stand and walk around the office to gather supplies, use office equipment, or collaborate with employees or patients. Occasionally stand, stoop, and lift or move objects, equipment, and supplies weighing approximately 20-25 pounds up to 40-50 pounds. ***TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers.***

Description *** WORK AT HOME*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on diagnosing and treating disorders and injuries of the musculoskeletal system, allowing our patients to live their best lives. Ninety-plus years later, we are advancing the practice of orthopaedic surgery throughout the state. There are several reasons why TOA is an employer of choice; here are a few of them: - Stability -TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! - Impact -TOA'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 helping patients live their best lives. - Work Environment -The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. - Total Rewards -TOA offers a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit-sharing match to go along with your contributions. JOB SUMMARY The AR Specialist is an essential part of the TOA Central Business Office. As an AR Specialist, you will use your analytical, financial, and customer service skills to ensure that TOA claims filed to an insurance payer are processed accurately and in a timely manner. DUTIES AND RESPONSIBILITIES - Promptly identify any errors or other issues in claims processing. - Effectively following up on any unpaid balances. - Expeditiously bring any remaining balance to resolution. - Meet quality assurance and productivity standards by identifying and reconciling insurance balance accounts. - Identify denial trends and provide potential solutions while analyzing patient accounts utilizing our EPM system – Nextgen to determine appropriate action. - Review explanations of benefits details on denials. - Communicate with insurance payer representatives, patients, and TOA staff to ensure timely and accurate resolution of account transactions. This would include Commercial plans, Medicare/Medicare HMO plans, Medicaid/Medicaid HMO plans, and BCBSTN. - Prioritize assigned accounts to maximize aged accounts receivable resolution. - Review the explanation of benefit (EOB) documentation and notate accounts on collection activity to perform account resolution. - Operate within established guidelines and protocols, including providing backup documentation for our accounting and audit functions. - Collaborate closely with the Central Business Office, clinical colleagues, and administrative teammates to develop a cohesive, high-performing team. - Adhere to HIPAA and OSHA safety guidelines. Requirements - Exceptional customer service and patient focus. - Knowledge of Insurance – particularly coordination of benefit rules and denial overturns are essential to this position. - Knowledge of administrative and clerical procedures. - Accustomed to using mostly payer websites for appeals/reconsiderations, medical records attachments, verification of benefits, and/or web-based claims follow-up. - Ability to communicate and work as a team. - Demonstrated proficiency with Microsoft Office programs such as Excel, Word, and Outlook. - At least 3 years insurance collections experience. - Experience using NextGen. - Orthopaedic specialty experience. - Fluency in English is required; Fluency in a second language is a plus. WORKING CONDITIONS TOA fosters an excellent working environment of positivity, collaboration, job satisfaction, and engagement. AR Specialist will be assigned to work in TOA’s Central Business Office at an assigned cubicle in a call center environment and from home occasionally. The department experiences high volume, and as a result, it has associated stressors that conflict with a fast-paced environment. The noise level in the work environment is moderate to loud, with other staff members answering phones and collaborating. Regularly sit while working on the computer; use hands and fingers to handle, control, or feel objects, too, ls commands; repeat the same movements when entering data; speak clearly so listeners can understand; understand the speech of another person; ability to differentiate between colors, shades, and brightness; read from a computer screen for extended periods time. Frequently stand and walk around the office to gather supplies, use office equipment, or collaborate with employees or patients. Occasionally stand, stoop, and lift or move objects, equipment, and supplies weighing approximately 20-25 pounds up to 40-50 pounds. ***TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers.***

Description ***Work from home*** The TOA Patient Access Representative is our patients' biggest advocate. This role provides patients with top notch customer service and understands TOA physicians, locations, and services inside and out to ensure our patients are getting connected to the best care possible for each unique situation. - Answer inbound calls from new and existing patients - Obtain patient demographics and insurance information - Listen actively to patient medical history such as surgical history, previous or current injuries, and recent imaging history - Dissect pertinent details such as patient address, availability, and specialty required in order to find the most convenient and effective appointment for the patient - Schedule patient appointments through NextGen - Use critical thinking and your expertise within TOA guidelines to arrive at solutions for patients- even if that means finding a creative resolution - Maneuver between multiple screens and multiple systems when documenting information and searching for physician availability - Review online appointment requests and schedule those appointments - Handle inbound referrals for your designated physician(s) - Reschedule cancellations - Respond effectively to time sensitive email communication - Deescalate conflict independently with disgruntled patients - Other duties as assigned Requirements - You have the drive to provide excellent customer service and execute that on a daily basis - It comes natural for you to maintain a professional and empathetic tone while conducting phone calls- even when call volumes are high and you’re multi-tasking - You enjoy corresponding over the phone - You’re very organized and pay close attention to detail - Working with computers comes easy to you- you know the basics of - Microsoft programs such as excel, word, and office - You enjoy being a part of a team that works collaboratively to achieve goals - You successfully work across boundaries, including other TOA roles and clinics - Knowledge of patient appointment scheduling is a plus - Previous experience working with an EMR, such as NextGen (or similar documentation systems) is preferred - High school degree is required, a college degree is preferred TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers.

Description *** WORK AT HOME*** Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: - Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! - Impact - TOA’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 helping patients live their best life. - Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. - Total Rewards - TOA offers a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit-sharing match to go along with your contributions. The Financial Counselor is an important link in the TOA revenue cycle effort. While most of our collections are through insurance companies, this role focuses on individuals who are in a "self-pay" mode. The result is a TOA employee who understands the importance of interpersonal communication and customer service in direct conversations with TOA patients and their designated representatives. - Work the daily appointments - Open balances and print statements for front desk to collect at check-in - Meet face to face with patients regarding balances on their account - Explain patient benefits (Deductibles, Co-pays, & Co-insurance amounts) - Set up payment plans - Submit adjustment requests - Request patient refunds - Assist front desk with check-out - Pre-service collections ( Surgery deposit, ESI, & High Dollar Drugs) - Schedule patients for appointments or follow-ups - Work the self-pay report(aging report & work log) - Follow-up on insurance denials - Collect patient payments - Any additional task assigned by Site Manager or Front Desk Supervisor Requirements - Demonstrated success in a revenue cylce or healthcare business office environment, specifically with self-pay or insurance collections. - Exceptional focus on Customer Service. - Strong, positive, telephone communication skills - Ability to read and understand payer remittance advices - Ability to differentiate between allowed charges, contractual adjustments, line item denials / reasons, patient responsibility (co-pay, co-insurance, and deductibles), bundled payments, etc. - Must be able to meet average expectations for productivity and quality standards - Must possess detail orientation, and the ability to recognize patient address changes, typing errors, medical coding mistakes, or other revenue cycle errors. - Ability to organize and prioritize day-to-day tasks to keep work assignments current. - Strong mathematical skills to accurately apply discounts and to ensure correct patient balances - Proficient in MS-Excel for analyzing data using basic formulas, pivot tables, and charts. TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers