Billing Specialist

Job Title:  Billing Specialist                                                FLSA: Non-exempt              

Reports To:   Claims Support Supervisor                             Status: Full-time       

Last Update: 3/27/2025                                               

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: The Billing Specialist ensures correct medical (CPT, HCPCS) and diagnosis (ICD-10) codes are used for services provided and verifies that patient information is complete and accurate before submitting clean claim to payor(s) in a timely manner by use of electronic EMR system and clearinghouse. The Billing Specialist will follow up on payor rejected claims and addressing claim errors once 837 is translated into clearinghouse.

Supervisory Responsibilities: 

·         None

Essential Functions:

·         Review diagnosis and procedure codes that are used for services provided for accuracy.

·         Reviewing patient insurance information is complete and accurate before submitting claims.

·         Attaching medical records to claim when necessary for billing purposes.

·         EDI file transmission.

·         Monitoring claim error and rejections in clearinghouse.

·         Claim resubmission projects.

·         Perform other duties as necessary.

Qualifications:

·         Current CPR/First Aid/Narcan training.

·         Current and annual negative TB Test.

·         Current and valid Fingerprint Clearance Card.

·         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:

·         Thorough working knowledge of billing guidelines, requirements and regulations for all insurance companies, AHCCCS, Medicare, etc.

·         Must be proficient with computer, Microsoft Office and EMR systems.  

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

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

·         Ability to work under minimal supervision.

·         Ability to type at least 40 WPM.

Education & Experience:

·         Minimum of High School Diploma or GED required.

·         Minimum of 3 years of experience medical billing and coding, preferred.

·         Medical and behavioral health experience preferred.

·         Experience with NextGen/Topaz EHR software a plus.

·         Experience with billing through Clearinghouses and running reports.

·         Experience with all technical aspects of electronic billing. 

·         Exhibits understanding of CPT, HCPCS and ICD-10 codes

Work Environment:

·         Fast paced behavioral health office 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.