Job Description
Ni2 Health is actively recruiting a AR Specialist to join our Team. The AR Specialist is responsible for accurate billing, and insurance follow-up for hospital services provided by a Critical Access Hospital (CAH). This position works to ensure timely claims submission, payment resolution, denial management, and collection of outstanding balances while maintaining compliance with Medicare, Medicaid, commercial payer, and regulatory requirements. The ideal candidate possesses strong knowledge of hospital billing workflows, payer requirements, and revenue cycle best practices. The Business Office Specialist will:
- Review and submit accurate hospital inpatient, outpatient, emergency department, observation, swing bed, and ancillary service claims
- Verify claim accuracy prior to submission, including demographics, insurance coverage, authorizations, and coding completeness
- Monitor electronic claim submissions and resolve claim edits and rejections
- Utilize clearinghouse tools to identify and correct rejected claims promptly
- Work closely with Patient Access, Health Information Management (HIM), Coding, and Clinical departments to resolve billing issues
- Perform comprehensive 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 root causes of payment delays and recommend corrective actions
- Document all payer contracts, actions taken, and account resolutions within the patient accounting system
- Communicate directly with commercial insurance carriers, Medicare Advantage plans, Medicaid, and Blue Cross Blue Shield representatives regarding claim status and payment disputes
- Maintain thorough 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
- Assist with reducing aged receivables and improving cash optimization
- Maintain compliance with all federal, state, payer, and hospital regulations
- Adhere to HIPAA privacy and security standards
- Follow Critical Access Hospital billing and reimbursement guidelines
- Support internal and external audits as requested
ABOUT NI2 HEALTH, an Infinx Company
At Ni2 Health, you will discover challenges that excite you as you develop professionally and explore different career paths based on your interests and abilities. We reward ambitious, talented individuals with a work environment that fosters creativity, teamwork and collaboration while encouraging fresh thinking away from the way things have always been done.
Breaking the mold is a vital component to what we do at Ni2, and driving sustained value to our clients is paramount. Our team members and clients are completely satisfied with our service-based approach. If you are looking to be mentored as a new graduate, come explore Ni2 Health (www.ni2health.com) and join a team of stars.
A 2025 Great Place to Work®
In 2025, Infinx was certified as a Great Place to Work® in both the U.S. and India, underscoring our commitment to fostering a high-trust, high-performance workplace culture. This marks the fourth consecutive year that Infinx India has achieved certification and the first time the company has earned recognition in the U.S.
APPLICANT REQUIREMENTS AND SKILLS
Applicants must submit a full CV, cover letter and updated resume to be considered.
Position is remote.
Minimum Job Requirements
- High School Diploma or GED
- 3 years of hospital billing and/or accounts receivable follow-up
- Experience using MEDITECH hospital information system preferred
- Experience using Waystar clearinghouse and revenue cycle tools preferred
- Experience with Blue Cross Blue Shield (BCBS) payer billing and follow-up preferred
- Experience with Medicare Advantage payer follow-up and denial resolution preferred
- Critical Access Hospital billing experience strongly preferred
- 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
- Knowledge of Medicare cost-based reimbursement methodologies applicable to CAHs preferred
- Excellent written and verbal communication skills
- Strong analytical and problem-solving abilities
- Proficient in Microsoft Excel, Outlook, and other Microsoft Office applications
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.
