Accounts Receivable Specialist – Clinical AR Resources

Location: SPRING, TX

Compensation Rate – $20 – $24 Hourly

About The Company

Infinx Healthcare is a leading healthcare technology solutions company that supports revenue cycle management providers and hospital systems, which has been continuously changing the landscape of healthcare delivery.
Driven by focus and an entrepreneurial mindset, Infinx is a fun, fast-paced company that is disrupting the patient access and revenue cycle management markets within healthcare. We provide tech-enabled service solutions that leverage machine learning and artificial intelligence to provide a cloud-based platform and solutions for our customers. We are looking for passionate people to continue to bring new ideas and innovations to our team.

Summary Description

The Accounts Receivable Specialist for Clinical AR Resources 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.

Link to apply: Accounts Receivable Specialist (Healthcare): Clinical AR Resources – Spring, TX 77386 – Indeed.com