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Tennessee Orthopaedic Alliance

Insurance Verification Specialist and Patient Service Representative (PSR)

Tennessee Orthopaedic Alliance, Columbia, Tennessee, us, 38402

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Insurance Verification Specialist and Patient Service Representative (PSR) Position summary: The Verification of Insurance (VOI) Specialist plays an essential role in supporting our team by verifying benefits, securing authorizations, and assisting with administrative tasks to ensure a smooth and positive patient experience. This is a full-time, non-clinical position based in Columbia, TN.

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, family/significant others, insurance companies, and facility personnel to obtain information necessary to verify.

Resolve issues with coverage, referrals, precertification and escalate complicated issues to the immediate manager. Have a basic understanding of what a referral and an authorization are.

Enter and verify information in insurance fields; update information in the system as needed. This includes moving any VOBs, authorizations, and clinical referrals. If encounters were billed incorrectly, email collections for potential rebilling.

Familiar with facility concepts, practices, and procedures; rely on experience and judgment to plan and accomplish goals.

Required Qualifications

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

Knowledge of insurance processes, terminology, and workflows.

Experience reading and interpreting payer eligibility electronic returns, differentiating between insurance plans, copays, deductibles, 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.

Preferred Qualifications

Experience using NextGen software.

Benefits

Competitive pay

Comprehensive benefits package including medical, dental, and vision coverage

401(k) with employee match and discretionary profit-sharing

Paid Time Off (increases with years of service)

Paid holidays

TOA is an equal opportunity employer. TOA conducts background checks and drug screens on applicants who accept employment offers. TOA adheres to HIPAA and OSHA safety guidelines.

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