Remote Accounts Receivable Specialist

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.

• 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 
  various account types, 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.
  •  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.
  • 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.
  • Identify denials trends, root cause, and A/R impact.
  • Serve as a resource to other team members and assist Team Leads with identifying A/R and denials trends.
  • Other Duties as Assigned.

• • Must have had at least 2 years accounts receivable experience in a physician office setting.
  • General Knowledge of HCPCS, CPT-4 and ICD-10 coding and/or medical terminology.
  • Familiar with multiple payer requirements and regulations for claims processing.
  • Must have a High School Diploma/GED.

Expected hours for this role are 40 hours per week. Position is fully remote but requires one week of in-office training in Greenville, SC Support Center.

Monday - Friday schedule; candidates may start between 7 AM and 9 AM EST

• 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