Senior AR Specialist

Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery. We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients. Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and Virginia. As an equal opportunity employer, we celebrate diversity and are committed to an inclusive environment for all employees and patients.

Day in the Life of a Senior AR Specialist

• Performs all duties and responsibilities in accordance with local, state, and federal regulations and company policies.
• Utilize and apply industry knowledge to resolve new and aged accounts receivables by working complex in nature account denials, projects, and rejections including but not limited to professional claims, governmental and/or non-governmental claims, denied claims, aged accounts, high priority accounts, high dollar accounts, reimbursements, credits, etc.
• Leverage available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolutions, document all activity in accordance with organizational and client policies.
• Communicate professionally (in all forms) with payer resources to include websites/payer portals, e- mail, telephone, customer service departments, etc.
• Maintain quality and productivity results at a level that meets departmental standards as measured by a daily/weekly/monthly average.
• Research, trends, and resolves claims of a complex nature
• Understands remit and remark codes and demonstrates knowledge of resolving complex claim denials
• Escalates difficult/problem claims with predetermined next steps
• Reviews and resolves high dollar and/or highly complex outstanding insurance receivables
• Reviews claims data and supporting documentation to identify coding and/or billing concerns.
• Ability to interpret payer contracts and identify contract variances affecting reimbursement.
• Utilize knowledge of the cash posting processing to obtain the necessary information to resolve misapplied payments.
• Demonstrate clear proficiency in third-party billing requirements to include federal, state, and commercial/managed care payers.
• Interpret claim scrubber edits/rejections and takes appropriate action necessary to resolve issues.
• Seek resolution to problematic accounts and payment discrepancies.
• Prepare appeal letters for technical denials by accessing specific payer appeal forms, submitting appropriate medical documentation and tracking appeal resolution.
• Works with projects and groups to develop or change existing revenue cycle processes to accommodate changes in business model
• Analyze accounts with critical thinking; consider payer contracts and billing guidelines to ensure one- touch resolution.
• Further responsibilities may include reviewing insurance credit balances to determine root cause and take the steps necessary to resolve the account.
• Serve as a resource to other team members and assist Team Leads with identifying A/R and denials trends.
• Other Duties as Assigned.
  
  

Education And Experience Requirements

• High school diploma or equivalent.
• Preferred 4 years medical billing and Accounts Receivable – in a physician office setting.
• General knowledge of HCPCS and CPT coding.
• Working knowledge of practice management software and various payor portals
• Working knowledge with allowable/contractual amounts, payment terminology, adjustments, identifying patient responsibility.
  
  

Position Benefits

• Have a daily impact on many lives.
• Excellent training if you are new to this field.
• Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate.
• Community events that promotes belonging and education. Includes but not limited to community cook outs, various fairs related to addiction treatment and outreach, parades, addiction awareness for schools, and holiday events.
• Opportunity to save lives everyday!
  
  

Benefits Package

• Medical, Dental, and Vision Insurance
• PTO
• Variety of 401K options including a match program with no vesture period
• Annual Continuing Education Allowance (in related field)
• Life Insurance
• Short/Long Term Disability
• Paid maternity/paternity leave
• Mental Health day
• Calm subscription for all employees