Description

AR Specialist

Maximize Reimbursements Through Strategic Problem-Solving

Location: AICA Orthopedics Headquarters - Marietta, GA

Position Impact

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.

Core Responsibilities

Strategic Denial Management

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

Proactive Reimbursement Optimization

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

Technical Problem Resolution

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

Performance Expectations

Success in this role is measured by specific outcomes:

Meeting or exceeding monthly insurance recovery targets

Reducing average days in accounts receivable for assigned payers

Achieving strong appeal success rates through proper documentation and follow-up

Resolving assigned claims within established timeframes

Contributing to department's overall collection goal achievement

Qualifications & Skills

Required

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

Preferred

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

The Ideal Candidate

Approaches insurance recovery with the precision and thoroughness of an investigator

Demonstrates methodical persistence in pursuing appropriate reimbursement

Shows analytical thinking in identifying patterns and root causes of denials

Maintains exceptional organization to manage multiple accounts simultaneously

Communicates clearly and effectively with internal teams and payer representatives

Rewards & Growth Opportunities

Competitive hourly rate with potential for performance-based incentives

Clear path for advancement to Senior Specialist, Team Lead, or Management roles

Comprehensive benefits including medical, dental, vision, and 401(k)

Professional development and specialized certification opportunities

Ability to contribute directly to the financial health of a growing healthcare organization

About AICA Orthopedics

AICA Orthopedics is Atlanta's premier integrated healthcare provider specializing in orthopedic, neuro-spine, and pain management services. With 21 locations across metro Atlanta, we deliver multidisciplinary care through a collaborative team of specialists including orthopedic surgeons, neurologists, chiropractors, physical therapists, and pain management experts.

Ready to apply your analytical expertise to maximize insurance reimbursements while advancing your career in healthcare finance? Apply now!

Requirements