About us:
Hughston Clinic Orthopaedics has an exciting opportunity to join our family as a Precertification Coordinator at our Location Office.

At Hughston Clinic Orthopaedics, we put patients first. For over 75 years, Hughston has remained committed to providing high quality patient care. We have several locations in Nashville and the surrounding cities in Middle Tennessee.

Our mission is to provide world-class service for all our patients. We strive to be the best provider in orthopedic care, and continue to support and encourage our patients to resume a more active lifestyle. We are looking for candidates who put the needs of patients above all else, are ethical and honest, treat everyone with dignity and courtesy, and do the right things in the right way.

Hughston offers competitive pay plus comprehensive benefits, including Medical, Dental, Vision, Paid Time Off, Holiday Pay and more. Our 401(k) plan provides a company safe harbor contribution to help you get started in saving for your retirement.

Position Goal:

Complete the precertification and prior authorization process by calling insurance companies, adjusters, and patients. Communicate the approval or denial of surgeries and/or tests effectively to physicians, physicians’ staff, and patients.

Position Responsibilities: 

• Obtain precertification and prior authorization for patients scheduled for a surgical procedure and/or tests as ordered by physician.
• Obtain all necessary information required to obtain precertification or prior authorization to include clinical dictation and test results.
• Provide accurate information to insurance companies based on test results, clinical dictation, etc.
• Verify/re-verify insurance benefits and eligibility for each scheduled surgical procedure and/or test.
• Complete precertification and prior authorization process in a timely, efficient manner with respect to urgent requests.
• Collect any deductibles/co-pays prior to date of surgical procedure and/or test.
• Provide coverage for front office staff.
• Utilize effective communication skills (written and verbal) interacting with co-workers, other clinic employees, supervisors, and outside vendors.
• Promote Hughston Clinic Orthopaedics role in the community by greeting and interacting with all patients, families, visitors, vendors, and guests in a courteous and respectful manner.
• Provides support or relief for other staff as needed.
• Demonstrates confidentiality in all aspects to include both patient and non-patient issues.
• Reflect HCO values and is sensitive to HCO’s ethical and compliance principals in his/her daily activities.
• Promote resolution of concerns and conflict by routing through correct mechanism or resolving the situation.
• Able to prioritize daily functions/tasks
• Display a willingness to put forth effort in problem solving
• Other duties as assigned by management

Experience: One year precertification experience required. Experience in a medical setting preferred. Knowledge of medical insurance, medical terminology, and computer skills required.
Education: High School Diploma or equivalent required.
Special Qualifications:

Required:

• Must be able to work independently. 
• Must have working knowledge of HIPAA requirements.
• Must have a valid driver's license and satisfactory motor vehicle record (MVR). 

*Travel is required*

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.