Revenue Cycle Specialist

About the role

Acadia Healthcare's Comprehensive Treatment Centers (CTC) division operates 170+ CARF-accredited outpatient opioid treatment programs (OTPs) nationwide, serving patients undergoing treatment for opioid use disorder (OUD). As the leading provider of medication-assisted treatment (MAT) in the nation, we care for more than 74,000 patients daily. Our mission is to deliver comprehensive care, combining therapies with safe and effective medications. Our team stands at the forefront of the battle against the opioid epidemic.

Responsibilities

• Update patient Billing Episodes and credit accounts as appropriate.
• Review and resolve prior authorization/precertification/referral issues that are not valid; contact insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial.
• Validate all necessary referrals/prior authorizations/pre‑certifications for scheduled services are on file and shared with appropriate staff and are valid for the services performed.
• Ensure all account activity is documented in the appropriate system and shared with appropriate staff timely and thoroughly.
• Manage clinic emails throughout the day; respond to all clinic emails in a timely manner.
• Identify, correct and forward potential reimbursement problems to the Revenue Cycle Manager.
• Proactively interact with clinics and other staff sharing benefits, authorizations, and eligibility.
• Bill 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, EMRs and payer portals to review and correct claims and to resubmit electronically when available.
• Evaluate bill cycles and change/update when necessary.
• Print daily billing reports – both electronic and paper claims; monitor validation percent.
• Work daily claims rejection lists (including 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).
• Gather and interpret data from the system; understand appropriate courses of action and initiate 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 where appropriate.
• Identify trends and work with the Revenue Cycle Manager for resolution.
• Perform other duties as assigned.

Qualifications

• 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.
• Knowledge of office administration procedures with the ability to operate most standard office equipment.
• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
• Excellent interpersonal skills; ability to interact effectively and professionally with individuals at all levels; both internal and external.
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to the next level.
• Self‑motivated with strong organizational skills and superior attention to detail.
• Ability to manage multiple tasks/projects simultaneously within inflexible time frames.
• Ability to adapt to frequent priority changes.
• Capable of working within established policies, procedures and practices prescribed by the organization.
• English sufficient to provide and receive instructions/directions.

Benefits

• Comprehensive Medical, Dental, & Vision insurance
• Competitive 401(k) plan with company match
• Company paid group term life insurance and short‑term disability
• Generous PTO: Paid vacation, personal time, sick Leave, and extended sick leave
• Employee Assistance Program (EAP) offering continued support to employee lifestyle and well‑being
• Career advancement opportunities across a leading national network

Schedule

Monday‑Friday (7am‑5pm EST) – work 8 hours within this timeframe.