Billing Operations Supervisor

2 weeks ago

Phoenix, Arizona, United States Crossroads Inc Full time
Job Overview

Position Title: Claims Support Supervisor

FLSA Status: Exempt

Reports To: Chief Financial Officer

Employment Status: Full-time

Company Overview: Crossroads Inc. is a licensed provider in Arizona, specializing in substance abuse treatment. We are dedicated to delivering high-quality, effective, and affordable recovery programs for individuals, including men, women, and Veterans facing Substance Use Disorder.

Role Summary: The Claims Support Supervisor is responsible for managing the billing team and acting as a key point of contact between plan members, health insurance providers, and Crossroads' finance and programming departments. This role ensures the resolution of claims-related issues and oversees all communications with health insurance carriers, eligibility monitoring, and verification of benefits.

Key Responsibilities:

  • Recruit, interview, hire, and train team members.
  • Oversee daily operations and workflow management.
  • Conduct performance evaluations and provide constructive feedback.
  • Recommend adjustments to employee compensation.
  • Manage employee disciplinary actions in line with company policies.
  • Handle employee relations and timecard management.
  • Oversee paid time off (PTO) management.

Essential Duties:

  • Deliver timely and effective customer service to members, providers, insurers, and clients regarding healthcare claims.
  • Ensure prompt follow-up on account review requests.
  • Resolve various billing discrepancies and errors with insurance companies and clients.
  • Manage credentialing processes for all providers at Crossroads.
  • Engage with providers, third-party billers, and insurance companies to address claim issues.
  • Supervise eligibility checks and documentation within Electronic Health Records (EHR).
  • Analyze billing trends and patterns to identify areas for improvement.
  • Adapt operational processes to meet evolving business requirements.
  • Support the development of annual quality plans in collaboration with service line/process owners.
  • Maintain knowledge of insurance contracts and billing software rate schedules.
  • Ensure proper setup of all 835 and Electronic Fund Transfers (EFTs).
  • Conduct audits of billing software to verify correct payments from insurers.
  • Collaborate with peers and management across various functions.
  • Perform additional duties as necessary.

Qualifications:

  • CPR/First Aid/Narcan certification.
  • Annual negative TB test.

Knowledge, Skills, and Abilities:

  • Ability to analyze and interpret medical records and formulate clinical queries.
  • Strong organizational skills with the ability to prioritize tasks and work independently or as part of a team.
  • Exceptional critical thinking and communication skills, maintaining professional relationships with all stakeholders.

Education & Experience:

  • High school diploma or GED required; associate's degree or higher preferred.
  • 3-5 years of experience in health insurance billing.
  • Minimum of one year of experience with Electronic Medical Records (EMS) and quality assurance in a mental health setting.
  • Proficiency in Microsoft Office and experience in reporting and analytics.
  • Experience in non-profit organizations and knowledge of addiction and recovery preferred.

Work Environment:

  • Fast-paced behavioral health office environment.
  • Primarily indoor work, with occasional outdoor tasks.

Physical Requirements:

  • Regularly required to sit, speak, and hear; occasionally required to stand, walk, and lift up to 50 pounds.
  • Specific vision abilities required include color vision and depth perception.

Shift Requirements:

  • Availability for days, nights, weekends, and holidays.

Travel Requirements:

  • Valid Arizona Driver's License required.
  • May involve travel between various sites and locations.

EEO Statement:

Crossroads Inc. is committed to providing a workplace free from harassment and discrimination, ensuring all applicants and employees are treated equally.

ADA Acknowledgment:

Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions.

Benefits:

  • 401(k) with matching contributions.
  • Company-paid premiums for medical, dental, vision, and life insurance.
  • Supplemental life insurance and short-term disability coverage.
  • Paid time off and tuition reimbursement.

This position will remain open until filled.

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