AR Specialist

Infinx•, (Multiple States)

1d•$19 - $23•Remote

About The Position

Ni2 Health, an Infinx company, is recruiting an AR Specialist to handle accurate billing and insurance follow-up for services provided by a Critical Access Hospital (CAH). The role supports timely claim submission, payment resolution, denial management, and collection of outstanding balances while complying with Medicare, Medicaid, commercial payer, and regulatory requirements. The position calls for knowledge of hospital billing workflows, payer requirements, and revenue cycle practices. The role is remote.

Requirements

High school diploma or GED.
At least 3 years of hospital billing and/or accounts receivable follow-up experience.
Knowledge of hospital revenue cycle processes, including claim submission, payment posting review, denial management, appeals, and collections.
Experience working insurance balances and payer correspondence.
Strong understanding of Medicare, Medicaid, commercial insurance, and hospital billing regulations.
Excellent written and verbal communication skills.
Strong analytical and problem-solving abilities.
Proficiency in Microsoft Excel, Outlook, and other Microsoft Office applications.
Applicants must submit a full CV, cover letter, and updated resume to be considered.

Nice To Haves

Experience using the MEDITECH hospital information system.
Experience using Waystar clearinghouse and revenue cycle tools.
Experience with Blue Cross Blue Shield payer billing and follow-up.
Experience with Medicare Advantage payer follow-up and denial resolution.
Critical Access Hospital billing experience.
Knowledge of Medicare cost-based reimbursement methodologies applicable to Critical Access Hospitals.

Responsibilities

Review and submit accurate hospital inpatient, outpatient, emergency department, observation, swing bed, and ancillary service claims.
Verify claim accuracy before submission, including demographics, insurance coverage, authorizations, and coding completeness.
Monitor electronic claim submissions and resolve claim edits and rejections.
Use clearinghouse tools to identify and correct rejected claims promptly.
Work with Patient Access, Health Information Management (HIM), Coding, and Clinical departments to resolve billing issues.
Follow up on unpaid and underpaid insurance claims.
Investigate and resolve claim denials, rejections, and payer correspondence.
Appeal denied claims according to payer guidelines and timely filing requirements.
Monitor aging reports and prioritize accounts based on balance, payer, and filing deadlines.
Identify causes of payment delays and recommend corrective actions.
Document payer contacts, actions taken, and account resolutions in the patient accounting system.
Communicate with commercial insurance carriers, Medicare Advantage plans, Medicaid, and Blue Cross Blue Shield representatives about claim status and payment disputes.
Maintain knowledge of payer-specific billing requirements and reimbursement methodologies.
Monitor payer trends and communicate recurring issues to leadership.
Meet productivity and collection goals established by leadership.
Help reduce aged receivables and improve cash optimization.
Maintain compliance with federal, state, payer, and hospital regulations and HIPAA privacy and security standards.
Follow Critical Access Hospital billing and reimbursement guidelines.
Support internal and external audits as requested.