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
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
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
- 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
What We Do
ProCo is a medical management company that oversees the daily operations and back-end office workings of healthcare centers across the Southeast.
