Therapy Autho Coordinator

TOA; Clarksville (TN); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Paid Time Off

401(k) with company match

Job summary

Tennessee Orthopaedic Alliance (TOA) is seeking an Insurance Verification Specialist to support our Middle Tennessee clinics. The role focuses on verifying patient insurance, managing referrals and precertifications, and ensuring accuracy of insurance data in our systems.

Candidates should have 2–4 years of insurance verification experience, strong attention to detail, and the ability to follow established procedures. TOA offers competitive benefits and a collaborative work environment.

Qualifications

• High school diploma required.
• 2-4 years of experience in insurance verification preferred.
• Experience reading payer eligibility electronic returns and differentiating plans, copay, deductible, coinsurance.
• Ability to meet daily site verification expectations.
• Must be accurate, detail oriented, and able to organize and prioritize tasks.

Responsibilities

• Verify insurance coverage and eligibility for patients at the site.
• Resolve coverage, referrals, and precertification issues with supervision as needed.
• Enter and correct insurance information in the system; coordinate with collections if rebilling is required.
• Communicate with patients, families, and insurance companies to obtain necessary information.
• Adhere to procedures in VOI Training/Procedure Manual and follow established workflows.

Skills

Attention to detail

Organizational skills

Communication

Insurance verification

Payer eligibility interpretation

Education

High school diploma

Tools

Insurance verification software

VOI Training/Procedure Manual

Job description

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Nashville and Middle 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 nearly 20 locations!
• 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 on the current Middle Tennessee 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.
• 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 elevate 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 preferable.
• Must have experience reading and understanding payer eligibility electronic returns.Includes the ability to differentiate between insurance plans, copay, deductible, and coinsurance (patient responsibility).
• Must be able to meet average expectations for daily site verifications.
• Requires accuracy, attention to detail, ability to follow directions, organize and prioritize day-to-day tasks in order to keep work flow current

TOA is an equal opportunity employer. TOA conducts drug screens and background checks on applicants who accept employment offers

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.