Medical Assistant and Precertification Specialist at TOA Columbia

Columbia, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Feb, 26

Salary

0.0

Posted On

11 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Precertification, CPT Coding, ICD-10 Coding, Insurance Rules, Medical Terminology, Organizational Skills, Interpersonal Skills, Communication Skills, Detail-oriented, EHR Systems, Patient Education, Patient Care, Chart Review, Sanitization, Follow-up, Scheduling

Industry

Medical Practices

Description

Description 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.

Responsibilities

The Medical Assistant and Precertification Specialist is responsible for managing precertification processes and assisting in patient care. This includes communicating with insurance representatives, scheduling surgeries, and supporting providers during examinations.