AR Specialist

AICA Orthopedics, P.C.•Marietta, GA

1d•Onsite

About The Position

The Insurance Recovery Specialist plays a critical role in AICA Orthopedics' financial performance by systematically securing appropriate reimbursements across our 21 locations. This position requires methodical analysis, technical expertise, and persistent follow-up to ensure claims are processed correctly and paid in full. Your ability to navigate complex payer requirements, identify root causes of denials, and implement precise resolution strategies directly impacts the organization's revenue capture.

Requirements

2+ years experience in medical billing, insurance collections, or revenue cycle
Demonstrated success in denial management and claim resolution
Strong understanding of insurance reimbursement processes and medical coding
Excellent analytical and problem-solving abilities
Methodical approach to documentation and follow-up
Proficiency with NextGen, Salesforce, or similar healthcare/CRM systems
Attention to detail and commitment to accuracy

Nice To Haves

Experience with orthopedic, neurology, or physical therapy billing
Knowledge of personal injury cases and related insurance processes
Certification in medical billing or revenue cycle management (CPC, CPMA, etc.)
Background in healthcare administration or finance

Responsibilities

Analyze denied claims to identify specific reasons for rejection and determine optimal resolution paths
Apply in-depth knowledge of payer policies, medical coding, and documentation requirements to craft effective appeals
Implement systematic follow-up protocols based on payer-specific timelines and requirements
Document all actions, communications, and resolution steps with meticulous attention to detail
Track denial patterns to help identify and address systemic issues
Verify insurance benefits and secure necessary pre-authorizations to prevent future denials
Review and correct claim errors prior to submission when possible
Ensure all supporting documentation meets payer requirements for efficient processing
Reconcile payments against fee schedules to identify and address underpayments
Coordinate with clinical teams to obtain required documentation for successful appeals
Research complex claim issues using multiple information systems and payer portals
Apply detailed understanding of medical terminology and procedural requirements
Implement systematic approaches to resolve similar denials efficiently
Maintain current knowledge of changing payer policies and requirements
Apply critical thinking to develop solutions for unusual or complex reimbursement challenges