Job Description

CROSSROADS TREATMENT CENTERSwas founded on May 5, 2005 to serve a patient population with opioid addiction. Since its founding in 2005, the company has grown rapidly and now includes 90+ treatment centers in 10 states. Each member of the Crossroads team specializes in an area that supports the recovery of over 25,000 patients. Crossroads' clinical staff includes physicians, pharmacists, counselors, nurses, and other service coordinators. Along with medication management, our staff works closely with each patient to create an individualized treatment plan aimed at building recovery and relapse prevention skills.

We are currently seeking a strong Accounts Receivable Specialist, with extensive knowledge in open Claims Resolution to join our Revenue Cycle department.The AR Specialist is responsible for various aspects of billing and collections processes. The qualified candidate must strive to continuously streamline operations, improve processes, and ensure that billing practices are followed by the established guidelines. Responsible for maintenance of the revenue cycle process and other operational activities that support the overall billing and collection objectives. This job is located in Downtown Greenville, SC.

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Role and Responsibilities Responsible for the accurate and timely processing of claims.

• 75% Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.
• 20% Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
• 5% Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.

Requirements

• Responsible for all pre-bill edits and claim scrubber edits for accuracy and compliance with all government and commercial carriers billing guidelines before releasing for submission to payers.
• Understands and adheres to state and federal regulations and system policies regarding compliance, integrity and ethical billing practices.
• Must possess a good working knowledge of the UB04 and CMS 1500 claim form and the data elements/field data required
• Responsible to bill all services within a timely filing as defined by departmental goals and insurance guidelines.
• Must understand and comply with the rules regarding edits.
• Responsible for all billing related denials to identify trends to improve clean claim rates
• Responsible for multiple daily reporting of billing indicators through various reporting tools
• Must be able to accurately complete review and resolve all combined billing requirements to ensure compliance.
• Responsible to work all referrals within a 24/48-hour turnaround time from receipt.
• Must complete and retrain base training on all electronic billing systems.
• Other Duties as Assigned

REQUIRED SKILLS AND ABILITIES:

• Strong analytical, organizational skills.
• Strong oral and written communication skills.
• Good judgment skills.
• Basic business skills.
• Solid Microsoft Office skills required.
• Good communication skills and the ability to courteously interact with multiple departments

EXPERIENCE/EDUCATION REQUIRED

• Must have had at least 4 years electronic billing and/or billing editing experience in a hospital and/or physician office setting.
• General Knowledge of HCPCS, CPT-4 and ICD9-10 coding and/or medical terminology.
• Familiar with multiple payer requirements and regulations for claims processing
• Must have a High School Diploma/GED.