Infinx

• Review and analyze clinical documentation to assign accurate diagnosis, procedure, and service codes for facility and professional billing • Code inpatient, outpatient, emergency department, observation, clinic, and ambulatory surgery encounters • Assign ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, and applicable modifiers in accordance with official coding guidelines • Ensure coding accuracy, completeness, and compliance with CMS, Medicare, Medicaid, commercial payer, and regulatory requirements • Query providers when documentation lacks specificity necessary for accurate code assignment • Participate in coding quality reviews, audits, and education initiatives • Maintain productivity and quality standards established by the organization • Research coding regulations, payer policies, and reimbursement guidelines • Assist in denial management, appeals, charge capture reviews, and revenue cycle optimization efforts • Support onboarding and mentoring of junior coding staff when assigned • Assist in other duties as assigned.

• Accurately code medical records for hospital outpatient services; • Assign, sequence, edit and/or validate the appropriate ICD-10-CM and HCPCS/CPT codes for outpatient services provided by the hospital • Adhere to the Official CMS Coding Guidelines and Facility Coding Compliance policies and procedures • Ensure all charges are entered in EMR • Review and evaluate medical record documentation • Review and resolve coding edits, denials, rejections; • Assist in other duties as assigned.

• Lead and oversee the billing operations within the revenue cycle management process • Ensure accurate and timely billing for services rendered • Develop and implement strategies to optimize billing efficiency and revenue capture • Monitor and analyze billing performance metrics and indicators • Provide training, coaching, and mentorship to billing staff • Other duties as assigned

• Process accounts receivable payments and adjustments • Research and resolve AR discrepancies promptly • Follow up on outstanding/aged receivables • Maintain organized AR documentation • Identify opportunities to improve AR processes • Have proven experience with hospital inpatient, outpatient, CAH, Method I & II, RHC, and Provider-based billing and AR follow-up knowledge • Have a solid understanding of billing regulations related to Medicare and Medicare Advantage • Be able to function independently to complete timely and thorough follow-up on unresolved hospital and physician claims • Have strong proficiency in managing RTP and denied claims • Have a strong proficiency in preparing and submitting appeals and reconsiderations to health plans • Adapt quickly to proprietary tools and technology

• Own the customer success experience relationship with customers at various stages of their lifecycle post-close. • Manage the relationship with key, strategic, enterprise accounts. • Engage with Product and Engineering teams to incorporate and prioritize customer feedback. • Collaborate with operational leaders to maximize customer results and reduce client escalations. • Develop account plans for customers with customer-specific goals. • Work in partnership with marketing to identify and amplify the narrative of customer success stories. • Own the onboarding project schedules, including requirements analysis and priority negotiation. • Manage cross-functional team meetings with customers and internal teams with a high level of detail, effective communication, and analytical skills.

• Define and execute the product vision and strategy for the mid-cycle and backend RCM portfolio • Lead the roadmap for coding, billing, payment posting, AR & denials, and analytics to deliver measurable improvements in efficiency, accuracy, and financial performance • Partner closely with engineering and data teams in India to drive delivery excellence and foster cross-geo collaboration • Develop and manage a team of high-performing product managers and analysts, promoting a culture of accountability and innovation • Translate customer and market needs into actionable requirements and ensure products deliver strong ROI • Drive initiatives that leverage AI, workflow automation, and advanced analytics to enhance revenue integrity and operational performance • Collaborate with internal stakeholders across operations, sales, and implementation to ensure seamless product adoption and client success • Monitor market trends and emerging technologies to maintain competitive differentiation in the RCM space

• Processing, reviewing, and filing insurance to the resolution of the claim payment • Assisting patients with billing questions and the collection of patient balances • Performing various functions in the processing of insurance billing and collections, including Medicaid/Medicare claims • Collecting and entering patient's insurance information into ACS Compumed System • Reviewing, verifying, and submitting insurance claims • Processing correspondence from Third Party Payors and responding to patient requests • Following up with insurance companies and ensuring claims are paid in a timely manner • Resubmitting insurance claims that have received no response • Answering telephones and providing/obtaining information to resolve billing and collection issues • Maintaining supporting billing information for future reference or audit purposes

• Analyze patient accounts with credit balances, validating overpayment accuracy by evaluating EOBs, remittance advices, payment history, COB sequencing, and expected reimbursement before processing any refund • Identify root causes of credit balances including posting errors, duplicate payments, COB failures, contract variances, unapplied cash, and incorrect adjustments • Validate refund requests and takeback notifications from third-party payers against contracts, payment history, and claim adjudication to prevent inappropriate refunds • Research and resolve unapplied payments by reconciling remittance advices, deposits, and account histories to allocate funds to the correct accounts • Investigate complex multi-payer scenarios involving Medicare/Medicaid crossovers, third-party liability, workers' compensation, motor vehicle accident, and secondary/tertiary billing • Make independent, defensible decisions on challenging cases requiring interpretation of payer contracts, billing regulations, and revenue cycle policy • Coordinate with payment posting, AR follow-up, contract management, and patient financial services to resolve account issues at the root • Process patient and payer refunds accurately and timely in accordance with state escheatment laws and federal overpayment rules • Communicate professionally with insurance companies, patients, and internal departments regarding credit balance inquiries • Document all account activity and resolution steps with clear, concise, and actionable notes • Maintain productivity and quality standards in a high-volume, deadline-driven environment • Maintain full compliance with HIPAA, billing compliance, CMS regulations, and fraud/abuse regulations • Assignments may shift across client portfolios and credit balance categories based on volume and priority within the scope of the role

• Processing, reviewing, and filing insurance to the resolution of the claim payment. • Assist patients with billing questions and the collection of patient balances. • Perform various functions in the processing of insurance billing and collections, including Medicaid/Medicare claims according to the established policies and procedures. • Collect and enter patient's insurance information into ACS Compumed System. • Review, verify, and submit insurance claims. • Process correspondence from Third Party Payors and respond to patient requests. • Follow up with insurance companies and ensure claims are paid in a timely manner. • Resubmit insurance claims that have received no response. • Answer telephones and provide/obtain information to resolve billing and collection issues. • Maintain supporting billing information for future reference or audit purposes.

• Review hospital accounts for coding or documentation errors • Work with Ni2 team to analyze • Work with hospital staff to submit accounts for rebilling • Query physicians for additional information to support correct coding and billing • Gain exposure to our proprietary tools and technology • Travel to community hospitals and healthcare organizations to offer clients hands-on support • Other duties as assigned