AR Specialist, Surgery Center

Description

ABOUT TOA

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on diagnosing and treating disorders and injuries of the musculoskeletal system, allowing our patients to live their best lives. Ninety-plus years later, we are advancing the practice of orthopaedic surgery throughout the state. 

There are several 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 lives. 
• 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.

JOB SUMMARY

The AR Specialist is an essential part of the business office at the Surgery Center. As an AR Specialist,  A/R Specialist - must have a strong knowledge of medical collections, accounts receivables, insurance billing and verification, denial processing, appeal submission and EOB review. 

DUTIES AND RESPONSIBILITIES

•  Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay.
• Manage daily work queue.
• Send appeals or provide the requested medical documentation.
• Ability to review medical documentation to justify medical necessity.
• Review patient balances to ensure accuracy and follow up with patients to obtain payments.
• Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
• Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
• Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation.
• All other duties as needed.

Requirements

• 2+ years of ASC revenue cycle specifically with orthopedic experience.
• Ability to read and interpret insurance explanations of benefits and managed care contracts.
• Must communicate effectively, both verbally and in writing
• Must be able to multi-task and handle competing priorities
• Knowledge or experience working with a variety of health care insurance payers is preferred.
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
• HST, Waystar, RevSpring and/or ENVI experience preferred.
• High School Diploma or equivalent.

 Position will be M-F 9a-530p 

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