Crossroads

Manager

• Connect with patients monthly to address any needs and provide the resources to fulfill those needs
• Connect and maintain relationships with community partners for patient resources
• Work closely with a dedicated team to provide exceptional patient care
• Participate in community awareness/engagement events to promote Crossroads, our mission, our principles, and our approach to addiction treatment

Part-time Care Manager

Accounts Receivable

• Managing all aspects of revenue cycle day-to-day activities and processes in responsible area.
• Provides leadership in a team environment
• Responsible for specific team training and development of team members, providing feedback and monitoring.
• Responsible for recruiting, development and performance management within areas of responsibility.
• Prepares and analyzes reports for various departments pertaining to denials, assignments, trends, projects, and outcomes.
• Supports leadership in oversight of designated Revenue Cycle Management to ensure all RCM functions are worked within the established timeframes.
• Ensures that quality of work is maintained, and that compliance policies and procedures are followed through billing operations.
• Conduct team meetings to educate on trended issues, guidelines, process/protocol updates and complete re-training efforts as needed to maintain a high functioning team
• Maintain patient confidentiality and function within the guidelines of HIPAA
• Accomplishes staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards
• Provide resolution support and guidance surrounding all billing processes and the performance management of all direct reports.
• Promotes effective change management practices.
• Manages and prioritizes limited resources across multi-disciplinary, multi-site teams to maximize efficiency.
• Handles ambiguous situations in a productive and professional manner and leads others through such situations successfully.

Accounts Receivable Supervisor

Human Resources

• Ability to lead multiple EHR-related projects (implementations, integrations, upgrades and optimization)
• Identify opportunities for business optimization through use of existing system technology and operational capabilities to influence short- and long-term initiatives.
• Work across departments to collaboratively design, develop, document, train, and implement new data solutions and processes based on stakeholder needs.
• Develop and deliver presentations to leadership on key project status and expectations.
• Ability to collaborate with stakeholders with minimal supervision and align resources with project timelines in support of the Vice-President’s overall departmental expectations
• Enthusiasm for a fast-paced environment, continual change, and learning corporate applications/new software products as necessary to fully support the business.
• Establish governance and prioritization structures
• Lead change management for system updates
• Manage analysts, training, and support teams
• Manage the helpdesk to ensure tickets are triaged, assigned, and resolved quickly across the team.
• Configure systems for business requirements

Director of Clinical Applications – EHR Operations

Medical Billing and Coding

• Assign ICD-10-CM and CPT/HCPCS codes with modifiers for services provided in the facility (Professional fee coding)
• 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
• Ensures diagnosis codes meet local and national medical necessity guidelines
• 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 for all assigned services
• Demonstrates the technical competence to use the facility encoder and EMR in an office or remote setting
• Review and resolves coding edits and denials
• Assists with rebilling accounts when necessary
• Maintain a working knowledge of various laws, regulations and industry guidance that impact compliant coding
• Follow all HIPAA regulations and uphold a higher standard around privacy requirements
• Completes all assigned work in a timely manner based on internal and/or payer standards
• Must meet all coder productivity and quality goals; Maintain a 95% accuracy rate
• Attending and reporting at weekly team calls with Director of Medical Coding Compliance
• Reporting coding patterns identified within the coding process to management
• Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials
• Adhere to all internal competencies, behaviors, policies and procedures to ensure efficient work processes
• May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation

Medical Coder, CPC, CCS-P

Procurement

• Monitor inventory levels across clinics to ensure adequate supply while minimizing waste and overstock
• Coordinate with clinic staff and vendors to manage ordering, delivery schedules, and product availability
• Reconcile invoices and purchase orders in collaboration with the finance team to ensure accuracy and compliance
• Maintain accurate procurement and inventory records, including tracking usage trends and forecasting demand
• Support and enforce internal procurement policies and external regulatory requirements
• Provide training and support to clinic staff on procurement systems, inventory procedures, and compliance standards
• Identify process improvement opportunities to enhance efficiency, cost control, and operational effectiveness
• Serve as a liaison between operations, finance, and vendors to resolve procurement-related issues
• Support REMS & ICS audits and ensure documentation is complete and aligned with organizational and regulatory standards
• Lead and support go-live activities for new clinic openings, ensuring procurement and inventory processes are set up effectively
• Assist in developing and standardizing Buy & Bill (B&B) processes across all locations

Buy & Bill Procurement Lead

Community Manager

• Model INSPIRE culture at all times through interactions with employees, patients, referral partners, dignitaries and community members.
• Cultivate relationships that attract growth opportunities and foster strategic partnerships.
• Communicate company mission and vision clearly via written and oral presentations to community partners.
• Increase public awareness of our organization’s program and services with local community members.
• Plan and host educational and engaging events at Crossroads’ centers and within the community.

Community Engagement Manager

• Connect with patients monthly to address any needs and provide the resources to fulfill those needs.
• Connect and maintain relationships with community partners for patient resources.
• Work closely with a dedicated team to provide exceptional patient care.
• Participate in community awareness/engagement events to promote Crossroads, our mission, our principles, and our approach to addiction treatment.

Care Manager

• Performs all duties and responsibilities in accordance with local, state, and federal regulations and company policies.
• Utilize and apply industry knowledge to resolve new and aged accounts receivables by working various account types, including but not limited to professional claims, governmental and/or non-governmental claims, denied claims, aged accounts, high priority accounts, high dollar accounts, reimbursements, credits, etc.
• Leverage available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolutions, document all activity in accordance with organizational and client policies.
• Communicate professionally (in all forms) with payer resources to include websites/payer portals, e- mail, telephone, customer service departments, etc.
• Maintain quality and productivity results at a level that meets departmental standards as measured by a daily/weekly/monthly average.
• Reviews claims data and supporting documentation to identify coding and/or billing concerns.
• Ability to interpret payer contracts and identify contract variances affecting reimbursement.
• Utilize knowledge of the cash posting processing to obtain the necessary information to resolve misapplied payments.
• Demonstrate clear proficiency in third-party billing requirements to include federal, state, and commercial/managed care payers.
• Interpret claim scrubber edits/rejections and takes appropriate action necessary to resolve issues.
• Seek resolution to problematic accounts and payment discrepancies.
• Prepare appeal letters for technical denials by accessing specific payer appeal forms, submitting appropriate medical documentation, and tracking appeal resolution.
• Analyze accounts with critical thinking; consider payer contracts and billing guidelines to ensure one- touch resolution.
• Further responsibilities may include reviewing insurance credit balances to determine root cause and take the steps necessary to resolve the account.
• Identify denials trends, root cause, and A/R impact.
• Serve as a resource to other team members and assist Team Leads with identifying A/R and denials trends.
• Other Duties as Assigned.

AR Specialist – Medical Billing

Counselor

• Provides individual counseling to highly complex patients
• Conducts clinical assessments to appropriately assess patient’s treatment needs
• Designs and updates the patient’s treatment plan, including care coordination, referrals, and discharge planning
• Manages assigned caseload and compliance with clinical treatment requirements
• Collaborates with nurses and providers to provide holistic treatment services
• Facilitates urine drug screening for patients

Substance Abuse Counselor – OBOT

Compliance

• Obtains and maintains CLIA certificates of waiver for all CTC clinics.
• Coordinates with Regional Managers to ensure CLIA certificates are distributed to the appropriate centers.
• Oversees renewals of all existing CLIA certificates.
• Drafts and implements policies and tools related to CLIA compliance for all centers and full-scale labs.
• Submits change forms to CMS for all changes to laboratory directors and addresses listed on CLIA certificates.
• Maintaining CLIA compliance binders at all centers.
• Regularly checking licensing@ctc.care email and distributing emails to applicable team members.
• Conducts regulatory research as needed.
• Works with the Chief Compliance Officer to draft, update, and implement companywide compliance policies and procedures.
• Works with the applicable departments to distribute new policies and procedures.
• Collaborates with Regional Managers and Program Directors/Program Supervisors on compliance related projects and tasks.
• Maintains and organizes License Tracking Chart: sends bi-monthly state license reminder emails and follows up with applicable team members regarding license renewals and updates.
• Maintains and updates at least annually personnel file audit checklists.
• Attends weekly compliance team meetings: updates compliance work plan weekly prior to such weekly meetings.
• Assists with maintaining the Corporate Contact Excel spreadsheet and Master Center List Excel spreadsheet.
• Assists with maintaining tracking table for reported employee conflicts of interest.
• Attends monthly Compliance Review Committee meetings and records minutes and submits them to the Chief Compliance Officer for review and distribution in a timely manner.
• Attends bi-monthly DEA Compliance Task Force meetings and records minutes and submits them to the Chief Compliance Officer for review and distribution in a timely manner.
• Assists with contract management in Sharepoint and contract summary tables.
• Assists with compliance audits when needed.
• Supporting the Chief Compliance Officer and General Counsel with other duties as assigned.

Compliance Coordinator

Business Analyst

• Provide front-line support as a subject matter expert.
• Provide configuration assistance and workflow optimization for enterprise Practice Management and Billing systems.
• Support day-to-day operations by making decisions around trending issues.
• Manage and troubleshoot tickets.
• Support testing and go-lives.
• Assist end users to ensure stable, compliant, and efficient system usage across clinical and administrative teams.
• Provide Practice Management ticket decisions and execution, escalating when necessary.
• Troubleshoot issues as SME for end users.
• Monitor trending issues.
• Coordinate to onboard new services and locations.
• Assist Senior PM Analyst in special projects.
• Coordinate with Director Clinical Applications and other analysts as needed.
• Test changes made in certification system.
• Monitor production site for quality assurance.
• Document and log all system changes.
• Complete required trainings and mandatory training hours.

Practice Management Analyst I

• Conducting quantitative and qualitative clinical compliance audits of patient records within EHR systems to ensure compliance with the Crossroads Treatment Centers compliance programs and state and federal requirements.
• Assisting with the maintenance and revision of clinical compliance policies and procedures at various facilities located in 10 different states.
• Assisting with third-party payer audit requests.
• Responding to and investigating allegations of fraud, abuse and other non-compliance with state and federal laws and regulations and/or Crossroads Treatment Centers’ compliance policies and procedures and implementing corrective action plans as necessary.
• Identifying potential areas of compliance risk and developing and implementing corrective action plans for the effective resolution of compliance issues.
• Implementing, coordinating and/or overseeing internal and external audit procedures for the purpose of monitoring and detecting any misconduct or noncompliance.

Compliance Audit Coordinator

• Ensure compliance of all Crossroads Treatment Centers facilities (OBOTs and OTPs) with state boards of pharmacy, DEA, SAMHSA, and state regulations related to the prescribing, dispensing, and storage of pharmaceuticals.
• Develop process flows to help enhance key company initiatives.
• Perform daily analyses of trending data, special focus on business performance and outcome modeling.
• Collaborate with project management personnel to help support various company initiatives.
• Manage the use of technology (Power BI) for key metric review and reporting.
• Partner with the Data Analytics team to enhance and extract key data components for business reviews.
• Oversee and monitor medication inventory/reconciliation of medication inventory at all centers.
• Generate daily inventory reconciliation reports for specified OTP locations.
• Monitor completion of Biennial Inventory records.
• Ensure reports contain a complete and accurate record of all controlled substances on hand at each location.
• Coordinate with OTPs to ensure accurate inventory accountability audits are submitted each week.
• Assist the Director of DEA and Pharmacy Compliance with online ordering (CSOS) of Schedule II controlled substances.
• Track inventory usage in all OTP locations to ensure sufficient inventory is always on hand.
• Develop ordering thresholds and monitor for suspicious ordering.
• Monitor procurement recordkeeping.
• Oversee centralized (online) procurement recordkeeping.
• Serve as a liaison between OTP locations and medication distributors.
• Ensure distributors have accurate contact information, powers of attorney, and current lists of authorized receivers.
• Oversee returns of OTP medication.
• This includes medication returned to the manufacturer, distributor, or reverse distributor.
• Oversee transfer or distribution of OTP medication between OTP locations.
• Ensure recordkeeping is complete, accurate, and properly filed at each location and online.
• Monitor the specialty pharmacy injection trackers.
• Generate online administration and destruction records from injection tracker data.
• Prepare related reports.
• Generate monthly inventory reconciliation financial reports.
• Review monthly security system tests submitted by OTPs. Ensure systems are 100% functional.
• Maintain digital copies of required information that are readily retrievable during inspections by the DEA, BOP, or the Bureau of Drug Control.
• Coordinate with OTPs to ensure hard copies of all information are current and properly filed in the OTP’s DEA Inspection Binder.
• Assist Director of DEA Compliance with responding to and investigating allegations of fraud, abuse, and other non-compliance with state and federal laws and regulations related to the prescribing, dispensing, and storage of pharmaceuticals and/or Crossroads Treatment Centers’ compliance policies and procedures and implementing corrective action plans as necessary.
• Identifying potential areas of compliance risk and developing and implementing corrective action plans for the effective resolution of compliance issues related to the prescribing, dispensing, and storage of pharmaceuticals.
• Implementing, coordinating and/or overseeing internal and external audit procedures for the purpose of monitoring and detecting any misconduct or noncompliance related to the prescribing, dispensing, and storage of pharmaceuticals.
• Monthly and quarterly reporting, reviewing, and tracking related to audit results and Plans of Correction.
• Supporting the Director of DEA and Pharmacy Compliance with other duties as assigned.

Manager – DEA Compliance

• Provides individual counseling to highly complex patients.
• Conducts clinical assessments to appropriately assess patient’s treatment needs.
• Designs and updates the patient’s treatment plan, including care coordination, referrals, and discharge planning.
• Manages assigned caseload and compliance with clinical treatment requirements.
• Collaborates with nurses and providers to provide holistic treatment services.
• Facilitates urine drug screening for patients.

Substance Abuse Counselor – OTP

Business Intelligence Developer

• Support business partners with effective communication on metrics, benchmarks, and KPIs, with a special focus on financial and patient outcomes opportunity for new and existing projects
• Explore healthcare data sets and perform statistical analyses to discern and communicate business and industry trends using both new and established analytical solutions
• Prepare and communicate high-quality department reports on a set cadence (e.g., weekly, monthly, quarterly) using available technology (i.e., Excel, SQL, Power BI, R, etc.)
• Identify opportunities for business optimization through use of financial and operational data to influence short- and long-term strategy
• Work across departments to collaboratively design, develop, document, train, and implement new data solutions and processes based on stakeholder needs
• Gather requirements to translate technical and business needs; liaise between IT and business stakeholders to optimize tradeoffs
• Ability to collaborate with stakeholders with minimal supervision and quickly analyze/present data in meaningful ways
• Enthusiasm for a fast-paced environment, continual change, and learning corporate applications/new software products as necessary to fully support the business.