Eligibility/Billing Specialist at Crossroads Health

Crossroads Health, a 501(c)(3) non-profit organization with facilities located in Mentor, Painesville, and Cleveland, serves Northeast Ohio communities with comprehensive behavioral and primary integrated healthcare, early childhood services, extended housing and recovery services—no matter one’s ability to pay. Our mission is to provide hope, healing, and healthcare to everyone.

The Billing Specialist is responsible for the billing, payment posting, and collection of Crossroads’ accounts receivables. Parties responsible for payment include but are not limited to the client, third party insurances, Medicaid and the ADAMHS Board. It includes establishing clients and/or updating demographic information on the billing system, verifying all aspects of a client’s payment arrangements, recording payments, and expediting the collection of payments and resolution of past due accounts.

Essential Duties

Accounts Receivable: Responsible for billing clients, MACSIS (ADAMHS Board, Medicaid), insurances and all other potential billing parties in a timely manner. Verify client insurance coverage, request additional billing information from all sources if needed, record all billing payments made by all parties. Work within the team and payer structures to reduce outstanding accounts receivable. Assist in efforts that resort in additional reimbursement for Crossroads Health.

Eligibility: Research client insurance eligibility and responsible for updating client's account and programs to ensure correct insurance is being billed. Review client's entire account, update any and all encounters that are effective by any insurance update & rebill the encounters as needed.

Collections: Review's payment remittance for full benefit reimbursement. Resolves outstanding balances due to partial or nonpayment activity.

Payer Denials: Following up all claims that have been denied by payers to determine needs and effectively turn the denial into payment based on payer guidelines.

Customer Service: Work with the clinical team to effectively resolve issues related to billing claims. Works with clients, Crossroads’ management, ADAMHS Board, and ODJFS to pursue all available funding sources (i.e., TANF, 484, Title XX).

Our organization is committed to equal employment opportunity.    We do not discriminate against employees or applicants on the basis of race, color, religion, gender/sex (including pregnancy, childbirth, and pregnancy-related conditions), sexual orientation, gender identity, national origin, age, physical or mental disability, veteran status, uniform service member status, genetic information, or any other status protected by law. We are a drug free work environment, and all new hires will be required to take and pass a 10 panel drug screen which includes screening for THC.

Visit our website: www.crossroadshealth.org