Insurance Verification Specialist
About the job
- A high school diploma or equivalent is required.
- At least 5 years of experience in a healthcare setting is required; insurance verification experience is preferred.
- Strong knowledge of medical insurance plans, authorizations, and medical terminology is required.
- Experience with electronic medical record (EMR) systems is required; Epic experience is preferred.
- The role requires the ability to multitask and maintain accuracy in a fast-paced environment.
- The role requires clear communication, critical thinking, and organizational skills.
- The role requires the ability to work independently and collaboratively across departments.
- Contact insurance companies to verify pre-certification, pre-authorization, and medical necessity requirements for radiology and other outpatient procedures.
- Enter insurance and referral details accurately into the electronic medical record (EMR).
- Obtain cost estimates and communicate patients’ financial responsibility before procedures.
- Coordinate referrals and schedule appointments for magnetic resonance imaging (MRI) procedures and follow-up visits.
- Work with physicians and clinical staff to obtain documentation needed to support authorizations.
- Use critical thinking to prevent insurance denials and maximize reimbursement.
- Educate patients about their coverage, co-pays, deductibles, and referral expectations.
- Prioritize and manage incoming referrals and scheduling requests.
- Serve as a resource for staff on insurance plans, authorizations, and procedural codes.
- Provide coverage at clinic front desks as needed; on-site coverage may be sporadic and unplanned.
- Experience with insurance verification is preferred.
- Experience with Epic electronic medical record systems is preferred.
About the company
OrthoAtlanta treats bone, joint and muscle conditions for children and adults through orthopedic and sports medicine clinics. Its surgeons and rehabilitation specialists manage injuries and long-term problems, from fractures and arthritis to spine pain and joint replacement. Patients access consultations, diagnostic imaging, outpatient surgery and physical therapy through the practice, with treatment plans that include surgical and nonsurgical options. It bills health insurers and patients for medical care and accepts commercial insurance, Medicare and workers' compensation plans. OrthoAtlanta was founded in 2002 and is headquartered in Atlanta, Georgia.
Company Size
501-1,000
Company Stage
N/A
Total Funding
N/A
Headquarters
Atlanta, GA
Founded
2002
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Simplify's Take
What believers are saying
- Retirement support includes employer money: OrthoAtlanta lists an automatic 3% retirement-plan contribution and profit sharing.
- Further study has financial support: OrthoAtlanta lists tuition reimbursement among employee benefits.
- School sports ties broaden outreach: March 2026 brought an official provider partnership with the Georgia High School Association.
What critics are saying
- Patient access has insurer gatekeepers: OrthoAtlanta requires referral paperwork before initial visits when a patient's plan mandates it.
- Some roles require Piedmont access: current/former Piedmont employees risk withdrawn offers over denied Epic medical-record system reactivation.
- Austell applicants face travel screening: the medical assistant application asks about availability to cover other OrthoAtlanta clinics.
What makes OrthoAtlanta unique
- Physicians retain ownership: OrthoAtlanta describes itself as physician-owned while working under the Piedmont Orthopedics partnership.
- Workplace injuries have dedicated coordination: Healthy Return assigns workers' compensation coordinators to each OrthoAtlanta office.
- Management sits outside the clinical practice: IntraHealth Group supplies OrthoAtlanta's management services under a shared chief executive.
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