Medical Billing AR Specialist

Job Title:       Medical Billing Accounts Receivable (AR) Specialist              FLSA: Non-Exempt              

Reports To:   Claims Support Supervisor                                                  Status: Full-time       

Last Update: 2-20-2025                                                                             

Company Summary: Crossroads is an Arizona Department of Health Services licensed substance abuse treatment provider with proven expertise in serving men, women, and Veterans with Substance Use Disorder through the provision of high quality, successful, and affordable residential and outpatient recovery programs.

Due to federal contracts the following items are prohibited:  Medical/Recreational marijuana, current parole, or probation.  

Job Summary: Medical Billing Accounts Receivable (AR) Specialist is responsible for managing the medical billing accounts receivables and including denied and underpaid claims for clinic and behavioral health services, appeals and knowledge of payer policies.

Supervisory Responsibilities: 

·         None

Essential Functions:

·         Understanding of AR processes, healthcare billing, and familiar with regulatory standards such as HIPAA, HCPCS, CPT, and ICD-10 coding.

·         Communicates directly with payors to resolve denied or delayed claims and take appropriate actions to correct and re-submit claims.

·         Maintains detailed records of all collection activities, including follow-ups and resolutions.

·         Generates regular accounts receivable reports to monitor outstanding balances and track progress.

·         Ensures compliance with legal and regulatory guidelines related to debt collection.

·         Submit appeals according to payor guidelines as necessary.

·         Reviews overpayments and forwarding balances.

·         Work in conjunction with other billing staff to ensure timely filing.

·         Identify denial trends and determine process changes to prevent future denials.

·         Assist with or obtain pre-authorization as required by various carriers.

·         Performs other duties, as required.

Qualifications:

·         Current CPR/First Aid/Narcan training.

·         Current and annual negative TB Test.

·         Clean Motor Vehicle Record (MVR) check performed annually and upon hire, preferred.

·         Successfully pass a background check and an Arizona Department of Health Services Adult Protective Services check.

Knowledge, Skills, and Abilities:

·         Strong understanding of medical billing and coding systems

·         Knowledge of Medicare, Medicaid, and Commercial insurance.

·         Knowledge of Kipu and NextGen Office is preferred

·         Experience with Behavioral Health/Residential Treatment Center billing, preferred.

·         Ability to work independently and as a member of a team.

·         Ability to communicate effectively at multiple levels, both verbal and written.

Education & Experience:

·         Minimum of High School Diploma or GED required, associated degree preferred.

·         1-3 years of medical billing experience preferably in a behavioral health setting.

·         Medical Billing and Coding Certification preferred.

Work Environment:

·         Fast paced behavioral health setting.

·         Primarily indoors, however, some outdoor work may be requested.

Physical Demands:

·         While performing job duties, the employee is regularly required to sit and speak or hear. The employee is occasionally required to stand, walk, use hands to handle or feel, reach hands and arms, stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 50 pounds and seldom lift and/or move >100 pounds. Specific vision abilities required by this job include color vision, depth perception, and ability to adjust focus.

Shift Requirements: 

·         Days.

Travel:

·         Valid AZ Driver’s License. 

·         May include travel between sites and other locations.

·         Local and statewide travel when requested or required.

EEO:

·         Crossroads is committed to providing a workplace free from harassment and discrimination. We believe all applicants and employees should be treated equally without regard to an individual’s race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, or other non-merit-based factors.

ADA Acknowledgement:

·         To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions.

Benefits:

401(k) with matching of up to 3%

Company paid premiums for the full-time employee for Medical, Dental, Vision and Life Insurance

Supplemental Life Insurance and short-term disability

Paid time off

Tuition Reimbursement

If you require alternative methods of application or screening, you must approach the employer directly to request this.

This posting will remain open until filled and for a minimum of 7 days.