AR Specialist

****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.

• 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 employees 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.
• Work closely with Revenue Cycle, clinical, and administrative teams to foster collaboration and build a cohesive, high-performing team focused on achieving organizational goals.
• Adhere to HIPAA and OSHA safety guidelines.

• 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 at TOA’s Columbia at an assigned cubicle in a call center environment with the option to work remote. The department experiences high volume, and as a result, it has associated stressors that conflict with a fast-paced environment.

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.***