Autism Diagnosis Group
2 - 10 employees
👥 B2C
B2C
Autism Diagnosis Group is a clinical service provider that delivers professional autism evaluations and diagnostic services for both pediatric and adult patients, now operating as Josi Health. They offer rapid, accessible telehealth-friendly assessments (including at-home evaluations), accept major insurance plans and provide self-pay options, and include care concierge, detailed reports, and follow-up debriefs to support patients and families across most U. S. states.
Revenue Cycle Management Specialist
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🕒 Yesterday
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Autism Diagnosis Group
2 - 10 employees
👥 B2C
B2C
Autism Diagnosis Group is a clinical service provider that delivers professional autism evaluations and diagnostic services for both pediatric and adult patients, now operating as Josi Health. They offer rapid, accessible telehealth-friendly assessments (including at-home evaluations), accept major insurance plans and provide self-pay options, and include care concierge, detailed reports, and follow-up debriefs to support patients and families across most U. S. states.
📋 Description
• Own the full claims lifecycle – from claim submission and scrubbing to payment posting, AR follow-up, and denial resolution • Ensure that every claim is submitted accurately, every denial is challenged, and every payment is reconciled • Catch errors before claims go out, follow up relentlessly on unpaid claims, and identify patterns that prevent denials from happening in the first place • Prepare, review, and submit accurate claims to commercial payers (e.g., Aetna, Cigna, Blue Cross Blue Shield, UnitedHealthcare, Optum) • Verify and ensure the accuracy of billing codes (CPT, HCPCS, ICD-10) and modifiers for services rendered, with a focus on behavioral health and virtual care codes • Scrub claims for errors in demographics, eligibility, authorization, coding completeness, and payer-specific requirements before submission • Maintain up-to-date knowledge of commercial insurance billing requirements, with a focus on behavioral health and telehealth regulations • Use billing software and clearinghouses to process and track claims • Ensure timely filing requirements are met for all assigned payers • Monitor claim status and follow up on unpaid, underpaid, and denied claims promptly • Investigate and resolve claim discrepancies, denials, and appeals • Submit corrected claims and appeals when necessary • Maintain AR aging across assigned payer relationships – work buckets by age and priority • Review EOBs and denial trends to identify recurring issues and root causes • Generate reports for outstanding accounts receivable and payment trends • Post insurance and patient payments accurately (manual and electronic) • Reconcile ERA/EOB payments against expected reimbursement • Identify and resolve underpayments, overpayments, and credit balances • Process refunds to insurance and patients in compliance with regulations • Ensure all billing practices comply with federal, state, and local regulations • Verify patient insurance information, eligibility, and prior authorization requirements • Maintain accurate records of billing activities and patient accounts • Follow HIPAA regulations to ensure patient confidentiality • Support internal audits and quality reviews as requested • Collaborate with office staff, clinical teams, and payers to address billing and reimbursement issues • Provide clear communication to patients regarding their billing, payments, and financial responsibilities • Respond to inquiries from payers, patients, and colleagues in a professional and timely manner • Flag recurring pre-submission error patterns with recommendations for upstream fixes
🎯 Requirements
• 2+ years of experience in medical billing, AR follow-up, claims processing, or revenue cycle operations • Knowledge of CPT, HCPCS, and ICD-10 coding • Experience with claim clearinghouses and payer portals • Experienced with CMS 1500 forms • Expert knowledge of Google Sheets/Excel to create their own reporting & analysis • Strong attention to detail – you catch errors before they become rejections • Ability to manage multiple claims and deadlines simultaneously • Familiarity with Availity and other payer portals • Proactive follow-through – you don't wait for payers to respond; you call them • Excellent written and spoken English communication skills • Reliable remote work setup with backup power and internet (EST hours)
🏖️ Benefits
• Fully remote – work from anywhere outside the US • Competitive monthly compensation in USD • Ownership of a critical function with direct impact on revenue • Autonomy – we trust you to own your deadlines • Supportive, collaborative team culture
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