Medical Assistant and Precertification Specialist Job at Tennessee Orthopaedic Alliance, Columbia, TN

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  • Tennessee Orthopaedic Alliance
  • Columbia, TN

Job Description

Medical Assistant and Precertification Specialist

Columbia, TN $29,090 - $34,900 (1 month ago)

Precertification Specialist Duties


  • Promptly identify and resolve errors or issues related to precertification and test/surgery scheduling.
  • Communicate with insurance payer representatives, patients, and employees to ensure timely and accurate scheduling for surgeries and procedures (including Commercial plans, Medicare/Medicare HMO, Medicaid/Medicaid HMO, BCBSTN, etc.).
  • Operate within established guidelines and protocols, including submitting required documentation (office notes, test reports, etc.) to insurance carriers.
  • Obtain pre-certification/pre-authorization from insurance companies prior to tests or procedures.
  • Manage patient insurance verification using insurance websites, phone, fax, and other available methods.
  • Perform timely follow?up on all submitted verifications and pre-certifications.
  • Notify physicians promptly regarding denials, approvals, or related updates.
  • Communicate effectively and professionally with patients, physicians, and staff.


Medical Assistant Duties
  • Escort patients from the waiting room to exam rooms in a courteous manner.
  • Collect and record patient medical histories, vital signs, medication information, and allergies in the electronic health record (EHR).
  • Assist providers during patient examinations and procedures, including cast, splint, suture, and dressing removal, as well as injections and aspirations.
  • Update patient charts during visits, accurately documenting histories, physical exams, treatment plans, and provider notes using medical terminology and abbreviations.
  • Enter E&M/CPT codes and submit charges to the coding department.
  • Provide clear care?plan instructions and patient education, including reviewing home exercise programs.
  • Review charts for completeness and accuracy.
  • Clean and sanitize exam rooms between patients to maintain a safe and welcoming environment.


Requirements
  • Prior precertification experience.
  • Strong understanding of CPT and ICD?10 coding.
  • Knowledge of insurance rules, particularly coordination of benefits and overturning precertification denials.
  • Familiarity with administrative and clerical procedures.
  • Experience with NextGen or other electronic health record (EHR/EMR) systems (preferred).
  • Strong organizational and interpersonal skills.
  • Knowledge of medical terminology.
  • Ability to thrive in a fast?paced environment.
  • Excellent oral and written communication skills.
  • Detail?oriented with strong follow?through.


Benefits
  • Competitive pay.
  • Comprehensive benefits package, including medical, dental, vision, 401(k) with employer match, and discretionary profit?sharing.
  • Paid Time Off (increasing with years of service).
  • Paid Holidays.


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

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Job Tags

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