• Job Description

  Req#: 247452
  Join the Diversus Health Team: Where Your Career Meets Purpose and Well-being!
  
  At Diversus Health, we're dedicated to transforming mental and behavioral healthcare to improve lives. Our mission is to provide trusted, affordable, and personalized care that empowers individuals to lead healthier, more fulfilling lives. And we're doing it with a team of passionate professionals who believe in the power of making a difference every day.
  
  When you join our team, you're not just another employee-you're part of a community that values your growth, well-being, and success. We live by our core values:
  
  Teamwork - We achieve more together.
  Solution-Minded - We embrace problems as opportunities.
  Impactful - We inspire positive outcomes.
  Integrity - We commit to do what is right.
  Our Rich Benefits Package Includes:
  
  • Exceptional Health Benefits (medical, dental, vision)-comprehensive coverage for you and your family's health needs.
  • 401(k) Company Match with 4% fully vested-planning for your future made easier.
  • Generous Vacation & Sick Time-because we know work-life balance is essential for your well-being.
  • Paid Long-Term Disability Coverage-peace of mind for those unexpected times when you need it.
  • Paid Holidays including 3 Floating Holidays-take the time you need to recharge on your terms.
  • Employee Assistance Program-including free therapy access to support your mental health.
  • Professional Development Funds-we invest in your growth through courses, conferences, and certifications.
  • Robust Training Program-get the skills and knowledge you need to excel in your career.
  • Second Language Monthly Bonus (subject to assessment)-for those with bilingual skills, earn extra for your ability to connect with more individuals.
  
  Job Summary: The Accounts Receivable, Accounts Specialist I is responsible for the timely submission of insurance, Medicaid, Medicare, grant, and self-pay claims, both electronically and on paper. Works with insurance carriers to verify claims, maximize collections, and resolve aged accounts. Maintains knowledge of claims processing policies and monitors patient databases for accuracy. Serves as a team player, consistently meeting performance standards and improving overall team efficiency. Communicates effectively with all stakeholders to enhance the patient experience at Diversus Health.
  
  Essential Functions:
  
  • Generate and submit claims accurately and timely under direct supervision.
  • Review basic remittance advice/EOBs for denied claim adjustments and identify resolve common denials and claim adjustments
  • Perform routine collection calls and follow up on outstanding patient balances.
  • Assist in resolving and resubmitting denied or rejected claims, re-submit claims, and file appeals.
  • Interact with patients to establish payment plans and ensure compliance.
  • Review and post insurance and patient payments.
  • Ensure all claims billed and collected meet insurance carrier standards.
  • Accurately document patient payment agreements.
  • Provide a positive customer service experience when interacting with patients.
  • Effectively decipher and explain account activity.
  • Assist Accounts Receivable Specialist II and III in research and resolution of complex billing issues.
  • Consistently demonstrates professionalism during interactions with internal and external customers.
  
  
  Knowledge/Skills/Abilities:
  
  • 0-2 years of medical billing/account receivable experience in a healthcare setting.
  • Basic knowledge of electronic medical billing and familiarity with EHR systems.
  • Working knowledge of Medicare, Medicaid and Commercial payer guidelines.
  • Strong verbal and written communication skills.
  • Ability to work independently on routine tasks and escalate complex issues.
  • Ability to organize and prioritize work to meet all deadlines and established goals.
  • Ability to handle sensitive information in a confidential and discreet manner.
  • Ability to handle high volume workload with a high degree of accuracy.
  • Proficient in Microsoft Excel
  • Basic knowledge of ICD, HCPCS and CPT coding, service modifiers and medical terminology.
  • Knowledge of insurance carriers' payment regulations including various reimbursement schemes, coinsurance and deductibles, and contractual adjustments (Medicare, Medicaid, managed care and commercial insurances).
  
  At Diversus Health, we believe in creating a truly healthy society, where mental and behavioral healthcare work together to improve lives.
  
  Join our team and help us make this vision a reality. Together, we can build a better tomorrow.
  
  Ready to make an impact? Apply today!
  
  Job Title: Accounts Specialist, AR
  
  Reports To: Manager, Accounts Receivable
  
  FLSA Status: Non-Exempt
  
  Working Location: REMOTE- expectation is to be in-office 2x/week during initial onboarding period (30 days)
  
  Job Summary: The Accounts Receivable, Accounts Specialist is responsible for the timely submission of insurance, Medicaid, Medicare, grant, and self-pay claims, both electronically and on paper. Works with insurance carriers to verify claims, maximize collections, and resolve aged accounts. Maintains knowledge of claims processing policies and monitors patient databases for accuracy. Serves as a team leader, consistently meeting performance standards and improving overall team efficiency. Participates in training for new team members and communicates effectively with all stakeholders to enhance the patient experience at Diversus Health.
  
  Essential Functions:
  
  • Generate and submit claims accurately and timely.
  • Review Remittance Advice/EOBs for denied claim adjustments and identify solutions to overcome denials in order to resubmit claims for payment.
  • Perform collection calls.
  • Resolve denied or rejected claims, re-submit claims, and file appeals.
  • Interact with patients to establish payment plans and ensure compliance.
  • Review and post insurance and patient payments.
  • Ensure all claims billed and collected meet insurance carrier standards.
  • Accurately document patient payment agreements.
  • Provide a positive customer service experience when interacting with patients.
  • Effectively decipher and explain account activity.
  • Consistently demonstrates professionalism during interactions with internal and external customers.
  • The environment at Diversus Health is fluid and roles and responsibilities may be altered to accommodate changing business conditions and objectives. Employees may be asked to perform duties that are outside of specific work that is listed within their job descriptions. This position may require you to work standard hours, as well as flexible hours both before and after standard hours, and may include work in excess of 40 hours in a work week as necessary to the position's needs.
  • Mobility Clause: Based on business need, this position may be needed to work and/or travel on a temporary basis at any premises which the agency currently has or may subsequently acquire or at any premises at which it may from time to time provide services. This position may require that the employee travel with or without notice as needed within the scope of the position responsibility.
  
  
  Knowledge/Skills/Abilities:
  
  • Minimum of 1 year of medical billing/account receivable experience in a healthcare setting.
  • Demonstrate understanding of integrated care claims process and Electronic Health Record database maintenance.
  • Knowledge of electronic medical billing.
  • Strong knowledge of Medicare, Medicaid and Commercial payer guidelines and use of service modifiers.
  • Strong verbal and written communication skills.
  • Ability to work with minimal supervision in an individual and team setting.
  • Ability to organize and prioritize work to meet all deadlines and established goals.
  • Ability to handle sensitive information in a confidential and discreet manner.
  • Ability to handle high volume workload with a high degree of accuracy.
  • Proficient in Microsoft Excel
  • Knowledge of ICD, HCPCS and CPT coding, service modifiers and medical terminology.
  • Knowledge of insurance carriers' payment regulations including various reimbursement schemes, coinsurance and deductibles, and contractual adjustments (Medicare, Medicaid, managed care and commercial insurances).
  • Embodies a commitment to:
  • Passion: a commitment to being present in the moment to create excitement and allow individuals to utilize their passion in daily functions. Help individuals connect their daily responsibilities with Diversus Health's larger mission
  • Humility: Level setting with all parties and advocates for all voices within Diversus Health
  • Corporate Citizenship: continued commitment to behave ethically and contribute to economic development while improving the quality of life of our workforce and their families, as well as of the local community and society at large.
  • Value in diversity: ability to recognize the value in differing perspectives, culture, etc., and leveraging those diverse components to develop experiences aligned with our internal and external communities
  • Innovation: thinking differently than the status quo to explore opportunities that provide a competitive advantage.
  • FUN: Contribute to, and be part of, an environment where individuals feel joy, comfort and connected to the organization's larger initiatives, while simultaneously experiencing a sense of cultural acceptance and belonging
  • Integration: cross functional implementation of theory, principles, and best practices from across the behavioral health industry in order to improve execution of strategies and deliver high quality experiences
  • Excellence: unwavering commitment to work that reflects the standard our colleagues and persons expect and deserve.
  • Transparency: communication, steward of resources, and the mistakes one makes (Fail/Fail Fast/Fail Fast Forward), while giving credit where it is due.
  • Safety: speaks to interconnectedness of all facets (departments and personnel) of the organization

• About the company

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