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Tennessee Orthopaedic Alliance · 1 month ago

Insurance Verification Specialist and Patient Service Representative (PSR)

Columbia,TN,US

Full-time

Onsite

New Grad, Entry Level

Tennessee Orthopaedic Alliance is seeking an Insurance Verification Specialist to support their clinic operations team. This role involves verifying insurance benefits, securing authorizations, and assisting with various administrative tasks to enhance the patient experience.

Health CareMedical

Responsibilities

Verify benefits and obtain authorizations if needed

Cross-train and assist at the front desk, including: Scheduling appointments

Assisting with patient check-in/out

Completing reports (e.g. task preregistration completion)

Collecting account payments and copays

Communicate professionally with patients (in person and by phone) and team members to support excellent customer service

Demonstrate working knowledge of: Electronic documentation systems

Microsoft Office Suite

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 for resolving 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

Qualification

Insurance processes knowledgeNextGen software experienceElectronic documentation systemsMicrosoft Office SuiteProfessional demeanorCustomer service commitmentCommunication skills

Required

Prior experience collecting copays, deductibles, coinsurance, and outstanding balances

Knowledge of insurance processes, terminology, and workflows

Experience reading and interpreting payer eligibility electronic returns, including the ability to differentiate between insurance plans, copay, deductible, and coinsurance (patient responsibility)

Familiarity with administrative and clerical processes

Strong communication skills, professional demeanor, and commitment to excellent customer service

Proficient in Microsoft Office Suite and comfortable learning new electronic systems