AR Specialist - Billing

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. #J-18808-Ljbffr Infinx