Insurance Verifier

Insurance VerifierAICA Orthopedics - Driving Revenue Performance Through Verification ExcellenceFor 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 OverviewThe 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 ImpactAs an Insurance Verifier, you'll drive financial results by:Maximizing revenue capture through comprehensive verification of all potential payment sourcesReducing claim denials through accurate pre-service verification and documentationAccelerating cash flow by identifying and addressing coverage issues before service deliveryImproving patient financial experience through clear communication about coverage and benefitsSupporting practice growth by enabling informed decisions about treatment authorizationThis position offers significant growth potential for professionals interested in revenue cycle management, healthcare finance, and insurance operations.Revenue OptimizationAchieve or exceed monthly verification targets that support departmental collection goalsIdentify and secure all available payment sources, prioritizing Med Pay and Major MedicalDocument and communicate coverage details that ensure clean claims submissionProactively identify and resolve potential reimbursement obstacles before they affect collectionsVerification Accuracy & EfficiencyMaintain high accuracy rates in benefit verification and documentationProcess 35+ patient accounts daily with thorough verificationComplete 25+ productive carrier and patient communications dailyEnsure all verification information is properly documented in case management and practice management systemsCommunication & CollaborationProvide timely alerts to clinical and corporate staff regarding coverage limitationsPartner with MP and MM teams to optimize billing of applicable policiesDeliver clear explanations to patients regarding financial responsibilitiesProcess ImprovementIdentify opportunities to streamline verification workflowsContribute ideas to enhance team performance and productivityAdapt quickly to evolving payer requirements and internal processesHelp develop best practices for personal injury and medical benefits verificationQualifications For SuccessRequired: High School diploma (college coursework a plus)2+ years of experience in insurance verificationProficiency with MS Office, Excel, and OutlookStrong communication skills with patients, insurance carriers, and internal teamsResults-oriented mindset with focus on measurable outcomesDetail-oriented approach with strong organizational abilitiesAbility to multitask in a fast-paced environment while maintaining accuracyPreferred: Experience with NextGen Practice ManagementKnowledge of medical billing terminology and processesPrevious experience in orthopedic or multi-specialty medical practicesUnderstanding of personal injury insurance and claims processesUnderstanding of health insurance and claims processesGrowth & Development OpportunitiesCareer Advancement: Pathway to senior verification specialist, team lead, or broader revenue cycle management rolesSkill Development: Ongoing training in insurance processes, healthcare reimbursement, and emerging payment modelsPerformance Recognition: Regular feedback and rewards for exceeding verification and collection targetsCross-Functional Exposure: Interaction with billing, collections, and clinical operations teamsWhat Sets Our Top Performers ApartTake ownership of verification metrics and their impact on overall collectionsApproach each account with thoroughness and attention to detailDevelop effective relationships with insurance representatives and attorney officesAnticipate potential coverage issues and proactively address themBalance efficiency with accuracy to maximize both productivity and revenueCompensation & BenefitsCompetitive hourly compensationPerformance-based bonus potentialComprehensive benefits packageProfessional development opportunitiesWork Environment40 hours per week with occasional extended hours to meet deadlinesFast-paced, metrics-driven environment with clear performance expectationsCollaborative team setting with opportunities to contribute to process improvementPhysical demands include frequent sitting, use of computer & phone systems, and occasional document handlingJoin 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.