Job Description

Job Description

Summary Description:

Join the fast-growing team at Infinx Healthcare, as we transform healthcare reimbursement and revenue cycle. For too long healthcare providers have struggled with healthcare payments, revenue leakage and reimbursements. This leads to less-than-ideal conditions for patient care and satisfaction. Our solutions and people remain focused on improving the revenue cycle continuum so that healthcare providers can take care of patients while we ensure they get paid. We work with the leading hospitals, health systems and physician groups across the country.

Good talent is the bedrock of our success. So, we treat our talent well, developing individual capabilities, kindling an entrepreneurial spirit, and ensuring that everyone has a rewarding and productive career here. That’s just part of our DNA. And it’s evidenced everywhere, from our fun and flexible work culture to our generous salaries, benefits packages, and defined career paths.

Working Hours Required 8:00 am - 5:00 pm (Central Time)

Location: In-person (Spring, Tx)

The Accounts Receivable Specialist will perform managed care insurance payment audit/underpayment identification, research, analysis, reporting, and collections functions. Ensures claims are paid appropriately pursuant to negotiated payment rates in the Hospital’s contractual agreements with managed care insurance payers. Reports all significant underpayment issues, trends, and systemic issues to Senior RCM Director to ensure there is no adverse effect on Hospital Cash Collections or Accounts Receivable. Keeps informed of managed care and contractual arrangements in order to resolve and process accounts by managed care insurance payers. Follows up on all payment variances for account resolution through insurance payer’s online tools, phone calls, and periodic in-person meetings with insurance payer liaisons. Ensure all accounts are resolved in a compliant manner and according to all applicable hospital policies/procedures, rules, and regulations.

Daily Responsibilities

• Research and re-bill unpaid claims
• Familiar with authorization procedures, appeals, redetermination, and reconsiderations
• Can create billing records requests
• Responsible for verifying insurance benefits or payment source on all patients
• Set up patient financial files specific to specialist
• Responsible for accurate computer data input on all patients, notes, and claims
• Generates invoices for insurance billing, individual account billing, and follow-up billing for deductibles and copays
• Research denied or pending claims and provides additional information to facilitate claim payment
• Negotiates with the responsible party on accounts more than sixty days past due. When unable to secure an agreement satisfactory to both parties, submits these accounts to the Client Services Manager for review prior to turning to private collection
• Required to always maintain confidentiality
• Research and resolve accounts appearing on Follow-up Reports
• Correct all errors on electronic error reports using all the available information
• Meet production and quality standards
• Assists in identifying current and/or potential billing issues specific to outstanding receivable
• Participates in daily production assignments that will continue to develop an understanding and knowledge of processing guidelines and expectations of respective client(s) payer mix

Skills and Education:

• 1 + years of relevant healthcare AR experience and / or customer service
• Experience working with claims billing and denials preferable
• Seeks continual professional development by updating current knowledge base regarding private insurance reimbursements
• Participates in staff meetings and offers appropriate and constructive suggestions and criticism
• Utilizes any extra time during decreased workload to assist other employees that may have extra workloads
• Organizes work in a manner to keep up with all the details of the job requirements
• Demonstrates competency in skills and knowledge pertinent to the practice of accounts receivable
• Demonstrates working knowledge of Insurance Company rules and regulations as pertaining to reimbursements for services rendered by Preferred
• Consistently performs routine tasks in an independent manner, while exercising good judgment during those instances when help may be needed, or a supervisor needs to be informed
• Utilizes proper chain of command when addressing concerns or problems
• Proficient computer skills with Microsoft Office: Excel, Word and Outlook
• Knowledge of ECW, Centricity, and/or Epic preferred
• Excellent Communication (Verbal & Written) Skills
• Data entry skills
• Strong work ethics and confidentiality
• Time management skills and attention to detail
• High school diploma or equivalent

Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Job Type: Full-time

Medical specialties:

• Cardiology
• Radiology
• ENT

Schedule:

• 8 hour shift
• Monday to Friday

Company Description

Enhanced Revenue Solutions (ERS), now part of Infinx Healthcare, is a revenue enhancement solution provider with extensive medical coding and billing expertise in a variety of healthcare specialties, such as cardiology and orthopedics. Our commitment to you allows us to become one with your existing team to successfully manage your practice on a daily basis. That way, you can spend less time trying to navigate the administrative red tape, and spend more time where it’s needed most — with your patients.

Company Description

Enhanced Revenue Solutions (ERS), now part of Infinx Healthcare, is a revenue enhancement solution provider with extensive medical coding and billing expertise in a variety of healthcare specialties, such as cardiology and orthopedics. Our commitment to you allows us to become one with your existing team to successfully manage your practice on a daily basis. That way, you can spend less time trying to navigate the administrative red tape, and spend more time where it’s needed most — with your patients.