Insurance Verification Specialist
About The Position
As an Insurance Verification Specialist at OrthoAtlanta, you'll play a key role in ensuring accurate and timely insurance processing for our patients. This role involves contacting insurance companies to verify pre-certification, pre-authorization, and medical necessity requirements for radiology and other outpatient procedures. You will also be responsible for entering insurance and referral details into the EMR, obtaining cost estimates, communicating patient financial responsibility, and coordinating referrals and appointments. A significant part of the role includes working closely with physicians and clinical staff to obtain necessary documentation, applying critical thinking to prevent insurance denials, and educating patients on their coverage. The specialist will prioritize and manage incoming referrals and scheduling requests, acting as a key resource for staff on insurance plans, authorizations, and procedural codes. Additionally, there may be a need to provide coverage at clinic front desks as needed.
Requirements
- High School Diploma or equivalent
- 5+ years of experience in a healthcare setting, preferably with insurance verification
- Strong knowledge of medical insurance plans, authorizations, and medical terminology
- Experience with EMR systems (Epic preferred)
- Ability to multitask and maintain accuracy in a fast-paced environment
- Excellent communication, critical thinking, and organizational skills
- Ability to work independently and collaboratively across departments
Nice To Haves
- Excel in a detail-oriented role and enjoy solving administrative challenges
- Communicate clearly and compassionately with both patients and staff
- Understand the complexity of insurance verification and referral coordination
- Are highly organized, deadline-driven, and self-motivated
- Thrive in a dynamic, team-based medical office environment
Responsibilities
- Contact insurance companies to verify pre-certification, pre-authorization, and medical necessity requirements for radiology and other outpatient procedures
- Enter insurance and referral details into the EMR with accuracy
- Obtain cost estimates and communicate patient financial responsibility prior to procedures
- Coordinate referrals and schedule appointments for MRIs and follow-up visits
- Work closely with physicians and clinical staff to obtain necessary documentation to support authorizations
- Apply critical thinking to prevent insurance denials and maximize reimbursement
- Educate patients on their coverage, co-pays, deductibles, and referral expectations
- Prioritize and manage incoming referrals and scheduling requests
- Act as a key resource for staff on insurance plans, authorizations, and procedural codes
- Provide coverage at clinic front desks as needed
Benefits
- Opportunities for professional growth and development
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
