AR Specialist
Nashville, TN Revenue Cycle
Job Type
Full-time
Description

***Remote - Work at Home***


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.

The AR Specialist is an essential part of the TOA Central Business Office. As an AR Specialist, you will use your analytical, financial, and customer service skills to ensure that TOA claims filed to an insurance payer are processed accurately and timely.

Responsibilities include:

  • Review patient accounts
  • Promptly identify any errors or other issues in claims processing
  • Effectively following up on any unpaid balances
  • Expeditiously bringing 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 TOA staff 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 explanation of benefit (EOB) documentation and notate accounts on collection activity to perform account resolution
  • Operate within established guidelines and protocols, including providing backup documentation for our accounting and audit functions
Requirements
  • College is preferred, and a high school diploma or equivalent is required.
  • At least 3 years insurance collections experience is preferred, with some experience in an orthopaedic practice a plus
  • Exceptional customer service and patient focus. Our Insurance Collections Specialists often speak with our patients, providers, and payors, and it is essential that they are able to make each encounter as positive as possible.
  • Knowledge of Insurance – particularly coordination of benefit rules and denial overturns are essential to this position.
  • Knowledge of administrative and clerical procedures, including experience with computer systems/Excel. Experience with an EHR or NextGen is a plus
  • Accustomed to using mostly payer websites for appeals/reconsiderations, medical records attachments, verification of benefits and/or web-based claims follow up
  • Collaboration, working closely with Central Business Office and clinical colleagues and administrative team mates to develop a cohesive, high performing team
  • An energetic and enthusiastic pace at work, with the ability to swiftly and accurately manage the flow documents through our EHR, without any diminishing focus on accuracy
  • Dependability, with a reliance on the capacity to be at work on-time, every day so our patients can receive the administrative support they need in a timely manner

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