EHR Revenue Cycle Management Systems Analyst - Remote in Greenville, SC or Eastern PA

Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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.

Day in the Life EHR Revenue Cycle Management Systems Analyst

EHR System Configuration & Integration

• Manage EHR system configurations related to Revenue Cycle Management (RCM), ensuring smooth integration between clinical documentation and billing systems.

• Oversee and maintain payor and provider setup within the EHR system, ensuring that data is mapped correctly for accurate claim submission.

• Leverage third-party integrations as necessary to help close product gaps in the EHR system, ensuring a seamless revenue cycle and enhanced functionality.

• Actively participate in the Steering Committee to evaluate, test, and coordinate the deployment of changes to the EHR system, ensuring effective communication across teams and smooth transitions to production.

Claims Management & Submission

• Support the generation of clean claims, ensuring all required data fields are captured and mapped in the system to minimize errors and rejections.

• Work closely with the RCM team to resolve any transmission issues and ensure that claims are submitted successfully.

Payment Processing & Reconciliation

• Work closely with the RCM team to review payment responses from clearinghouses and payors, including remittance advices, denials, and adjustments, to identify trends and address any inconsistencies.

• Work closely with the RCM team to analyze payment data to ensure accurate reconciliation between billed amounts, payments received, and adjustments made.

• Work closely with the RCM team to investigate and resolve billing issues, rejections, and denials, including following up on unpaid claims to maximize timely revenue collection.

Ticket Management & Resolution

• Support the entire lifecycle of RCM-related support tickets, ensuring prompt acknowledgment, prioritization, and efficient resolution.

• Proactively monitor open RCM tickets, track progress, and manage escalations to ensure resolution within defined service level agreements (SLAs).

• Provide timely updates to stakeholders, documenting each step of the resolution process to enhance transparency and accountability.

System Upgrades & Integration

• Participate in the testing, implementation, and deployment of software upgrades and system integrations.

• Collaborate with IT and vendor teams to ensure smooth integration of the EHR system with other clinical and administrative systems used in the organization.

Cross-Department Collaboration

• Collaborate with the clinical, billing, and finance teams to ensure proper coding, billing, and documentation practices in alignment with payer requirements and regulatory standards.

• Provide input into system enhancements and process improvements to optimize revenue cycle workflows and minimize bottlenecks.

Financial Tracking & Reporting

• Partner with finance to help create and maintain a subledger for tracking all revenue cycle activities.

• Assist with tracking bad debt, ensuring accurate reporting and follow-up on outstanding balances and uncollected payments.

Support Training

• Create comprehensive RCM training resources, including guides, tutorials, and FAQs, focused on RCM systems and processes, tailored for trainers to use with end-users.

• Lead training sessions for selected trainers or team leads within the revenue cycle department, equipping them with the knowledge and tools to effectively train their respective teams on system functionalities, claim management, and RCM best practices.

• Offer continuous support to trainers, gather feedback from them on training effectiveness, and update materials to ensure they align with evolving RCM processes and minimize system-related errors.

Compliance & Auditing

• Conduct regular audits and assessments of claims, payment data, and EHR system functionality to ensure compliance with healthcare regulations, payer-specific requirements, and organizational policies.

• Ensure the security and confidentiality of patient and financial data, adhering to HIPAA and other applicable privacy standards.

Location

• Remote but living in Eastern PA or Greenville, SC with some travel to Corporate as needed (Greenville, SC).

Education and Requirements

• Bachelor's degree in health information management, Healthcare Administration, or a related field (or equivalent experience).

• Minimum of 3-5 years of experience working with EHR systems (such as CareLogic, Medgen, Epic, Cerner, or similar) in a healthcare environment, specifically in Revenue Cycle Management.

• In-depth knowledge of claims generation, payor and provider setup, clearinghouse submission, and payment processing.

• Strong understanding of opioid treatment programs, their unique billing needs, and regulatory requirements.

• Familiarity with medical coding, billing processes, and insurance reimbursement.

• Experience with payment response analysis, including remittance processing, denials management, and payment reconciliations.

• Problem-solving skills with the ability to troubleshoot EHR system issues and resolve revenue cycle challenges.

• Excellent communication skills, both written and verbal, with the ability to collaborate effectively across teams.

• Strong attention to detail and the ability to handle multiple tasks in a fast-paced environment.

• Knowledge of healthcare regulatory standards, including HIPAA and payer-specific requirements.

Preferred Qualifications

• Certification in Health Information Management (e.g., RHIA, RHIT, or CCS).

• Experience with opioid treatment center billing and Medicaid/Medicare reimbursement models.

• Familiarity with electronic billing software and EDI processes.

Position Benefits

• Medical, Dental, and Vision Insurance

• PTO

• Variety of 401K options including a match program with no vesture period

• Life Insurance

• Short/Long Term Disability

• Paid maternity/paternity leave

• Mental Health Day

• Calm subscription for all employees