AR Specialist - Onsite

About Our Company:

At Infinx, we are a dynamic and rapidly expanding company dedicated to providing innovative technology solutions and services tailored to our clients' needs. Our mission is to collaborate closely with healthcare providers, leveraging automation and intelligence to overcome revenue cycle challenges and enhance reimbursements for patient care. We work diligently to ensure that our clients receive their revenue on time, every time. Our clientele includes physician groups, hospitals, pharmacies, and dental groups.

We are in search of experienced associates and partners who exude confidence and possess expertise in areas aligned with our clients' requirements. We value individuals who are passionate about assisting others, adept at finding solutions to challenges, and committed to improving patient care while maximizing revenue. Inclusivity and diversity are at the core of our values, fostering a workplace where employees feel a sense of belonging, their contributions are valued, and diverse perspectives are celebrated. We believe in the power of human connection, with inclusion as the heart of our mission.

Location: On-site in Spring, TX with expected work hours from 8:30 AM to 5PM CT Mon-Fri. 

Summary Description: 

The Accounts Receivable Specialist will be responsible for hospital compliance and quality improvement programs and will monitor compliance with billing rules/regulations by conducting reviews/audits of medical record notes to the billing department; evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to facility and technical fee documentation, coding and billing, including federal and state regulations and guidelines, CMS and other third party payor billing rules, and OIG compliance standards. You will be working on an Orthopedic account with back-up duties on a Cardiology account with a focus on Workers’ Compensation claims as well as be required to sometimes follow up on complex claims denials.

Job Responsibilities:

• Maintain multiple claim statuses to convert open AR into dollars collected, deposited, and posted into our client’s accounts
• Interact with internal departments such as Customer Service, Medical Management, Configuration, Contracting, Claims, and Provider Relations, as well as providers and other external entities, to process provider disputes efficiently and appropriately.
• Conduct standardized audit scoring methodology to consistently evaluate documentation and coding, and standardized audit findings methodology to report audit results.
• Communicate audit results to hospital service departments and departmental leadership, physicians, physician leadership, senior hospital management, coders, billers and other appropriate staff, provide physician and coder education and make recommendations for management corrective action.
• Serve as institutional subject matter experts and authoritative resources on interpretation and application of documentation and coding rules and regulations, medical necessity of services delivered, and conduct enterprise risk assessments of potential and detected compliance deficiencies.
• Investigate provider disputes to determine the source of the complaint.
• Use appropriate, understandable correspondence to communicate decisions.
• Ensure revenue integrity
• Maintain CDI process
• Responsible for charge capture
• Work directly with the manager to meet the needs of the department.
• Other departmental Ad Hoc Payment Integrity functions

Skills and Education: 

• Understanding of Medicare and Medicaid billing rules. Knowledge of Microsoft Office Suite software.
• A bachelor's or associate's degree in a related field is preferred.
• 2 years of experience in health insurance/managed care.
• Knowledge of medical terminology is preferred.
• Excellent written and oral communication skills
• Microsoft office products will be included in PC proficiency.
• The option of a hybrid schedule will be considered.

Company Benefits and Perks:

Joining Infinx comes with an array of benefits, flexible work hours when possible, and a genuine sense of belonging to a dynamic and growing organization.

• Access to a 401(k) Retirement Savings Plan.
• Comprehensive Medical, Dental, and Vision Coverage.
• Paid Time Off
• Paid Holidays.
• Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.

If you are a dedicated and experienced AR Specialist ready to contribute to our mission and be part of our diverse and inclusive community, we invite you to apply and join our team at Infinx.