Insurance Verification Specialist

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Nashville and Middle Tennessee, specializing in the diagnosis and treatment of musculoskeletal disorders and injuries. With over 90 years of service, TOA operates more than 20 locations across the state, fostering a positive, collaborative work environment focused on patient care and community impact.

About the role

The Insurance Verification Specialist is responsible for the timely verification of medical insurance benefits. Daily activities may include some or all of the following essential functions, depending on individual experience and organizational needs:

• Utilize the Workflow Daily Appointment Report for your site as a primary source for insurance verification and determining compatibility with TOA’s managed care plans.
• Adhere to best practices and procedures outlined in the “VOI Training/Procedure Manual” for day-to-day follow-up tasks.
• Place phone calls to patients, their families, insurance companies, and facility personnel to gather necessary verification information.
• Resolve issues related to coverage, referrals, and precertification, escalating complex matters to the immediate manager. Requires a basic understanding of referrals and authorizations.
• Ensure accurate entry and updates of insurance information in the system, including correcting any misbilled encounters and notifying collections for rebilling if needed.
• Move VOBs, authorizations, and clinical referrals as required.
• Apply experience and judgment to plan and accomplish goals, demonstrating familiarity with facility concepts, practices, and procedures.

Requirements

• High school diploma required.
• 2-4 years of experience in insurance verification preferred.
• Experience reading and interpreting payer eligibility electronic returns, with the ability to differentiate between insurance plans, copays, deductibles, and coinsurance.
• Strong accuracy, attention to detail, organizational skills, and ability to follow directions.

Benefits

• Competitive salaries based on the Middle Tennessee wage market.
• Comprehensive benefits package, including Medical and Dental coverage.
• Paid Time Off (PTO).
• 401(k) plan with company match, safe harbor match, and profit-sharing match.