Precertification & Insurance Authorization Coordinator

Tennessee Orthopaedic Alliance; Knoxville (TN); On-site; USD 25,000 - 39,000; Full time

Job summary

Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Tennessee, with more than 35 locations. We are seeking a precertification/authorization specialist to support patient access and streamline referrals.

You will verify benefits with insurers, obtain authorizations, correct any precert issues, and coordinate with physicians, staff, and patients to ensure timely approvals. TOA upholds Trust, Respect, Honesty, Teamwork, Communication, Diversity, and Accountability as

Qualifications

• Understanding of CPT and ICD-10 coding.
• Experience with EHR (NextGen) is a plus.
• Knowledge of insurance rules and precertification denials.
• Strong organizational and interpersonal skills.
• Understanding medical terminology.

Responsibilities

• Identify errors in precert and diagnostic testing.
• Communicate with insurer representatives, patients and staff to obtain authorizations.
• Provide backup documentation to carriers within guidelines.
• Obtain pre-certification/preauthorization from insurers before tests or procedures.
• Manage patient insurance verification via multiple channels.
• Follow up on all verifications/pre-certifications.
• Notify physicians regarding denials/approvals.

Skills

CPT & ICD-10 knowledge

Insurance coordination

Organizational skills

Interpersonal skills

Medical terminology

Tools

NextGen EHR

Job description

Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Tennessee, with more than 35 locations. We are seeking a precertification/authorization specialist to support patient access and streamline referrals.

You will verify benefits with insurers, obtain authorizations, correct any precert issues, and coordinate with physicians, staff, and patients to ensure timely approvals. TOA upholds Trust, Respect, Honesty, Teamwork, Communication, Diversity, and Accountability as