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.
Manage medical coding payer and recoupment reviews to ensure coding accuracy or appeal eligibility.
Review CPT/HCPCS codes from payer audits and recoupments to determine the appropriate documentation to support the services.
Review all applicable documentation of various providers to determine the appropriate codes to assign for all medical services, procedures, and diagnoses from available documentation within electronic medical records.
Be knowledgeable of billing and coding requirements for governmental and private insurance payers.
Utilize coding resources along with any other applicable reference material available to ensure accuracy in coding documentation for all assigned services.
Manage medical records request email and log request accordingly.
Initiates the medical record, ensuring that patient identifying information is on all documentation and accurate.
Communicate with payers and third parties on behalf of payers regarding medical record requests and portal access.
Compile medical records as needed for payer requests and third-party request on behalf of payers related to paid claims.
Process requests for information from outside sources in a prompt fashion, including answering phones and corresponding with outside entities to receive or send information.
Upload and enter medical records into the payer portal or send by other encrypted means of data transfer.
Responsible for safeguarding patient records in line with State and Federal regulation, as well as accreditation standards.
Assist with medical record audits, as needed, to ensure accuracy and quality.
Communicates with Lead Medical Coding Compliance Auditor and Director of Medical Coding Compliance about any chart discrepancies or deficiencies as well as large payer audits.
Working knowledge of HIPAA to ensure confidentiality of patient information and medical records.
Communicate with people of all levels in the organization and external agencies.
Track completion of Medical Records Request.
Manage incoming mail; sorting, logging, and redirecting as necessary.
Assist in providing data for summary reports for the Chief Compliance Officer.
Attending and reporting at weekly team calls with Lead Medical Coding Compliance Auditor, Director of Medical Coding Compliance, and Chief Compliance Officer.
Attend weekly meetings with other Medical Record Coordinators.
Determines method of completing daily workload and priorities to ensure that all responsibilities are carried out in a timely manner.
Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance or Chief Compliance Officer.
Certified Professional Coder (CPC®), CCS, CCS-P, CPC-A, or CCA preferred. Minimum CPC-A required.
High School diploma, GED or equivalent.
Minimum of 1 year of coding experience to identify correct ICD-10-CM and CPT/HCPCS codes preferred
1 Year working with Medical Records in a healthcare facility preferred
Understanding of medical terminology and administrative processes a plus
Computer literate adept skill level on MS Office applications.
Experience in Mental Health or Addiction Medicine a plus.
Candidates may start between 7:00 AM to 9:00 AM EST and work an eight-hour shift Monday through Friday.
Position is on-site in Downtown Greenville office.
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.
Opportunity to save lives every day!
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