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ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Hospital Billing (HB)Professional Billing (PB)Medicare billingAccounts Receivable (AR) managementMedicare Direct Data Entry (DDE)Claim processingDenial managementAppeals submissionUB-04CMS-1500
Soft Skills
LeadershipAnalytical skillsProblem-solving skillsCommunicationCollaboration
Tools & Technologies
Epic Resolute HB/PB
Industry Keywords
Healthcare AdministrationBilling operationsClaim validationClaim submissionComplianceMedicare regulationsBilling editsReimbursement delaysClean claim ratesRevenue Integrity
About the role
Key responsibilities & impact- Manage day-to-day Hospital Billing (HB) and Professional Billing (PB) billing operations
- Oversee claim generation, claim validation, and claim submission processes.
- Monitor and resolve billing edits, front-end claim rejections, and payer submission issues
- Manage Medicare Direct Data Entry (DDE) activities, including claim corrections, status reviews, RTP (Return to Provider) claims, and billing issue resolution
- Ensure claims are submitted accurately and within established filing deadline
- Develop and implement processes to improve clean claim rates and reduce avoidable rework
- Monitor billing work queues and productivity standards
- Coordinate with Coding, Revenue Integrity, Patient Financial Services, and Clinical departments to resolve billing-related issues
- Ensure compliance with Medicare, Medicaid, and commercial payer billing requirements
- Oversee Medicare AR follow-up activities for both HB and PB accounts.
- Monitor Medicare aging inventories and prioritize collection efforts.
- Manage resolution of unpaid, partially paid, and denied Medicare claims.
- Review and resolve RTP claims, denials, underpayments, medical necessity issues, coverage-related denials, and billing-related reimbursement delays
- Ensure timely and effective appeal submission when appropriate.
- Identify denial and AR trends and implement corrective action plans.
- Work closely with billing teams to address root causes impacting Medicare reimbursement
Requirements
What you’ll need- Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field
- Equivalent combination of education and experience may be considered
- 5+ years of experience in healthcare billing operations
- 3+ years of leadership experience managing billing and/or accounts receivable teams
- Extensive experience with both Hospital Billing (HB) and Professional Billing (PB) operations
- Strong Medicare billing and AR management experience
- Experience working with Medicare DDE
- Comprehensive understanding of Medicare billing regulations, DDE processes, claim edits and rejections, hospital billing (HB), professional billing (PB), Medicare AR follow-up and collections, as well as denial management and appeals
- Knowledge of UB-04 and CMS-1500 claim processing
- Strong analytical and problem-solving skills
- Experience with Epic Resolute HB/PB
Benefits
Comp & 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.
