Our Team:

We are improving the lives we touch. We need passionate, talented people working together who share our desire to create a world-class organization that sets the standard of excellence in the treatment of speciality behavioral health and addiction disorders. Acadia Healthcare is headquartered in Franklin, TN and is a leading provider of behavioral healthcare services in the nation. Our organization values input from employees and fosters collaboration to create a team oriented service delivery system. This position is in Providence, RI.

Our Benefits:

• Medical, dental, and vision insurance
• Acadia Healthcare 401(k) plan
• Paid vacation and sick time
• Opportunity for growth that is second to none in the industry

• Responsible for the timely verification of insurance benefits provided via websites and/or calling the payor.
• Responsible for updating patient Billing Episodes and crediting account, as appropriate.
• Obtain precertification and authorizations for services being rendered
• Review and resolves prior authorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial.
• Validates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed.
• Ensure all account activity is documented in the appropriate system and shared with all appropriate staff timely and thoroughly.
• Clinic Emails – responsible for managing clinic emails throughout the day (i.e., re-verification requests, balance inquiry, etc.). All clinic emails must be responded to by close of business daily.
• Identify and forward potential reimbursement problems to Revenue Cycle Manager.
• Proactively interacts with Clinics and other appropriate staff sharing benefits, authorizations and eligibility.
• Responsible for billing all patient claims in a timely manner (weekly billing, secondary and out-of-network plans).
• Review claims issues make corrections as needed and rebill. Utilize claims clearinghouse to review and correct claims and to resubmit electronically when available.
• Responsible for evaluating bill cycles and changing/updating when necessary.
• Responsible for printing daily billing reports – both electronic and paper claims. Monitor validation percent.
• Work daily claims rejection lists including but not limited to; claims rejected due to auto eligibility process during weekly billing and “Rejected” claims due to eligibility, coordination of care and authorization as part of accounts receivable.
• Gathers and interprets data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
• Call and status outstanding claims with third party payors.
• Review explanation of benefits to ascertain that claim processed and paid correctly.
• Document account follow-up in Waystar (clearinghouse).
• Identify trends and work with the Revenue Cycle Manager for resolution.
• Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
• Weekly reporting to RBOD an overview of the week and participate in AR meetings.

Your Skills and Qualifications as a Revenue Cycle Specialist:

• High school diploma or equivalent; prefer some college or technical school coursework.
• 2+ years of healthcare billing/AR experience, preferred.
• Healthcare payor claims follow-up or accounts receivable experience.
• Healthcare background with payor appeals experience.
• Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.
• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.
• Self-motivated with strong organizational skills and superior attention to detail.
• Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes.