Insurance Verifier

AICA Orthopedics - Driving Revenue Performance Through Verification Excellence-

About AICA Orthopedics For 25 years, AICA Orthopedics has been a leader in integrated orthopedic care across metro Atlanta. With 21 locations and a state-of-the-art surgery center, we're a growing team of 400+ professionals committed to exceptional patient care. We're transforming healthcare delivery through our multidisciplinary approach that brings together orthopedic surgeons, neurologists, chiropractors, physical therapists, and pain management experts under one roof.


Position Overview The Insurance Verifier plays a critical role in AICA Orthopedics' financial performance by ensuring maximum appropriate reimbursement for patient services. As the frontline of our revenue cycle, you'll directly impact our practice's financial health by optimizing insurance verification processes, identifying all available payment sources, and establishing clear pathways to payment for services rendered.


Position Impact As an Insurance Verifier, you'll drive financial results by:

• Maximizing revenue capture through comprehensive verification of all potential payment sources
• Reducing claim denials through accurate pre-service verification and documentation
• Accelerating cash flow by identifying and addressing coverage issues before service delivery
• Improving patient financial experience through clear communication about coverage and benefits
• Supporting practice growth by enabling informed decisions about treatment authorization

This position offers significant growth potential for professionals interested in revenue cycle management, healthcare finance, and insurance operations.


Revenue Optimization

• Achieve or exceed monthly verification targets that support departmental collection goals
• Identify and secure all available payment sources, prioritizing Med Pay and Major Medical
• Document and communicate coverage details that ensure clean claims submission
• Proactively identify and resolve potential reimbursement obstacles before they affect collections

Verification Accuracy & Efficiency

• Maintain high accuracy rates in benefit verification and documentation
• Process 35+ patient accounts daily with thorough verification
• Complete 25+ productive carrier and patient communications daily
• Ensure all verification information is properly documented in case management and practice management systems

Communication & Collaboration

• Provide timely alerts to clinical and corporate staff regarding coverage limitations
• Partner with MP and MM teams to optimize billing of applicable policies
• Deliver clear explanations to patients regarding financial responsibilities

Process Improvement

• Identify opportunities to streamline verification workflows
• Contribute ideas to enhance team performance and productivity
• Adapt quickly to evolving payer requirements and internal processes
• Help develop best practices for personal injury and medical benefits verification

Qualifications For Success

• Required:
  • High School diploma (college coursework a plus)
  • 2+ years of experience in insurance verification
  • Proficiency with MS Office, Excel, and Outlook
  • Strong communication skills with patients, insurance carriers, and internal teams
  • Results-oriented mindset with focus on measurable outcomes
  • Detail-oriented approach with strong organizational abilities
  • Ability to multitask in a fast-paced environment while maintaining accuracy
• Preferred:
  • Experience with NextGen Practice Management
  • Knowledge of medical billing terminology and processes
  • Previous experience in orthopedic or multi-specialty medical practices
  • Understanding of personal injury insurance and claims processes
  • Understanding of health insurance and claims processes

Growth & Development Opportunities

• Career Advancement: Pathway to senior verification specialist, team lead, or broader revenue cycle management roles
• Skill Development: Ongoing training in insurance processes, healthcare reimbursement, and emerging payment models
• Performance Recognition: Regular feedback and rewards for exceeding verification and collection targets
• Cross-Functional Exposure: Interaction with billing, collections, and clinical operations teams

What Sets Our Top Performers Apart Our most successful Insurance Verifiers consistently:

• Take ownership of verification metrics and their impact on overall collections
• Approach each account with thoroughness and attention to detail
• Develop effective relationships with insurance representatives and attorney offices
• Anticipate potential coverage issues and proactively address them
• Balance efficiency with accuracy to maximize both productivity and revenue

Compensation & Benefits

• Competitive hourly compensation
• Performance-based bonus potential
• Comprehensive benefits package
• Professional development opportunities

Work Environment

• 40 hours per week with occasional extended hours to meet deadlines
• Fast-paced, metrics-driven environment with clear performance expectations
• Collaborative team setting with opportunities to contribute to process improvement
• Physical demands include frequent sitting, use of computer & phone systems, and occasional document handling

Join our team and make a measurable impact on our organization's financial success while building valuable expertise in healthcare revenue cycle management! AICA Orthopedics is an equal opportunity employer and values diversity in our organization. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.


Requirements

• Required:
  • High School diploma (college coursework a plus)
  • 2+ years of experience in insurance verification
  • Proficiency with MS Office, Excel, and Outlook
  • Strong communication skills with patients, insurance carriers, and internal teams
  • Results-oriented mindset with focus on measurable outcomes
  • Detail-oriented approach with strong organizational abilities
  • Ability to multitask in a fast-paced environment while maintaining accuracy
• Preferred:
  • Experience with NextGen Practice Management
  • Knowledge of medical billing terminology and processes
  • Previous experience in orthopedic or multi-specialty medical practices
  • Understanding of personal injury insurance and claims processes
  • Understanding of health insurance and claims processes